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Cardiac allograft vasculopathy

Michal Pazdernik, Zhi Chen, Helena Bedanova, Josef Kautzner, Vojtech Melenovsky, Vladimir Karmazin, Ivan Malek, Ales Tomasek, Eva Ozabalova, Jan Krejci, Janka Franekova, Andreas Wahle, Honghai Zhang, Tomas Kovarnik, Milan Sonka
BACKGROUND: Optical coherence tomography (OCT)-based studies of cardiac allograft vasculopathy (CAV) published thus far have focused mainly on frame-based qualitative analysis of the vascular wall. Full capabilities of this inherently 3-dimensional (3D) imaging modality to quantify CAV have not been fully exploited. METHODS: Coronary OCT imaging was performed at 1 month and 12 months after heart transplant (HTx) during routine surveillance cardiac catheterization...
April 6, 2018: Journal of Heart and Lung Transplantation
André Antunes, David Prieto, Carlos Pinto, Carlos Branco, Pedro Correia, Manuel Batista, Manuel Antunes
INTRODUCTION: Coronary allograft vasculopathy (CAV) is still a serious long-term complication after cardiac transplantation. PURPOSE: To evaluate the prevalence of CAV in a single institution, its impact on survival and to explore associated risk factors. METHODS: From November-2003 through June-2016, 316 patients were submitted to cardiac transplantation. After excluding those with paediatric age (n=8), those with previous renal or hepatic transplantation (n=2) and those who didn't survive the first year after cardiac transplantation (n=40), the study population resulted in 266 patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Annika Gocht, Jörg H W Distler, Bernd Spriewald, Martina Ramsperger-Gleixner, Michael Weyand, Stephan M Ensminger, Christian Heim
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the main obstacle for long-term survival after heart transplantation. Alloimmune mediated chronic vascular rejection results in several mechanisms like platelet activation, immigration of inflammatory cells through the endothelial layer and proliferation and migration of smooth muscle cells (SMCs). Serotonin (5-HT) promotes these processes via activation of 5-HT2 receptors. We hypothesized that inhibiting 5-HT2 receptors ameliorates the development of CAV...
April 9, 2018: Transplant Immunology
Guillaume Coutance, Lucas Van Aelst, Guillaume Hékimian, Charles Vidal, Philippe Rouvier, Samir Saheb, Chantal Gautreau, Pascal Leprince, Shaida Varnous
BACKGROUND: Data are scarce on the prognosis of heart allograft antibody-mediated rejection (AMR) with cardiogenic shock (CS). METHODS: We performed a retrospective, single center, observational study. We included patients with biopsy proven AMR and CS. We aimed to analyze the characteristics, treatment and prognosis of patients treated for CS due to AMR. Patients alive after AMR were followed to analyze recurrences of AMR, graft function and cardiac allograft vasculopathy (CAV)...
April 7, 2018: Clinical Transplantation
Osama Omrani, Moheeb Alawwami, Jehad Buraiki, Nedim Selimovic
BACKGROUND: HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients. OBJECTIVE: To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients. DESIGN: Retrospective cohort study. SETTING: Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014...
March 2018: Annals of Saudi Medicine
J R Harris, J J Teuteberg, M A Shullo
Cardiac allograft vasculopathy is a major risk factor influencing graft loss and patient survival following orthotopic heart transplant. Allograft vasculopathy is a multifactorial process which includes both immunologic and non-immunologic mechanisms. Given the non-immunological risk factors for vasculopathy, particularly hyperlipidemia, it is intuitive that reducing a patient's LDL would help attenuate the disease process. Multiple studies have shown benefits with the use of statin therapy. However, current heart transplant guidelines do not give a specific recommendation as to what LDL goal should be achieved in this patient population...
March 30, 2018: Clinical Transplantation
Michael Weis
No abstract text is available yet for this article.
April 3, 2018: Journal of the American College of Cardiology
Sharon Chih, Aun Yeong Chong, Fernanda Erthal, Robert A deKemp, Ross A Davies, Ellamae Stadnick, Derek Y So, Christopher Overgaard, George Wells, Lisa M Mielniczuk, Rob S B Beanlands
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure and death after heart transplantation. Absolute myocardial blood flow (MBF) quantification using rubidium 82 (Rb-82) positron emission tomography (PET) could enable evaluation of diagnostically challenging diffuse epicardial and microvascular disease in CAV. OBJECTIVES: The authors aimed to evaluate Rb-82 PET detection of CAV. METHODS: Consecutive transplant recipients undergoing coronary angiography were prospectively evaluated with PET, multivessel intravascular ultrasound (IVUS), and intracoronary hemodynamics...
April 3, 2018: Journal of the American College of Cardiology
Michael S Lee, Gentian Lluri, Will Finch, Kyung Woo Park
We evaluated our quarter-century experience with percutaneous coronary intervention (PCI) in patients with cardiac allograft vasculopathy (CAV). CAV is a progressive form of atherosclerosis that is characterized by diffuse intimal thickening. It is a major cause of morbidity and mortality after orthotopic heart transplantation (OHT). Effective treatment options are limited. PCI has been used as a palliative treatment in selected patients. We retrospectively analyzed 140 patients with CAV who underwent PCI from 1992 to 2017 at the University of California, Los Angeles (UCLA) Medical Center...
February 6, 2018: American Journal of Cardiology
Dario Gulin, Edvard Galic, Jozica Sikic
No abstract text is available yet for this article.
January 1, 2018: Progress in Transplantation
Johannes Goekler, Andreas Zuckermann, Alexandra Kaider, Philipp Angleitner, Emilio Osorio-Jaramillo, Roxana Moayedifar, Keziban Uyanik-Uenal, Frieda-Marie Kainz, Marco Masetti, Guenther Laufer, Arezu Z Aliabadi-Zuckermann
BACKGROUND: Evidence concerning an association between cytomegalovirus (CMV) infection and accelerated cardiac allograft vasculopathy (CAV) is inconclusive. METHODS: Data were analyzed retrospectively from 297 consecutive heart transplants between 1.1.2002 and 31.12.2012. Patients ≤ 18 years of age, survival and follow-up ≤ 1-year post-transplant and patients with early CAV were excluded. CMV-infection was diagnosed and monitored closely in the first year. CAV was diagnosed by coronary angiography via left heart catheterization and results were categorized according to the International Society of Heart and Lung Transplantation (ISHLT) scoring system...
March 26, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Heidi J Reich, Jon A Kobashigawa, Tamar Aintablian, Danny Ramzy, Michelle M Kittleson, Fardad Esmailian
Using older donor hearts in cardiac transplantation may lead to inferior outcomes: older donors have more comorbidities that reduce graft quality, including coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia. Shorter cold ischemic times might overcome the detrimental effect of older donor age. We examined the relationship between donor allograft age and cold ischemic time on the long-term outcomes of heart transplant recipients. rom 1994 through 2010, surgeons at our hospital performed 745 heart transplantations...
February 2018: Texas Heart Institute Journal
Neslihan Arzu Akgün, Orçun Çiftci, Kerem Can Yılmaz, Emir Karaçağlar, Alp Aydınalp, Atilla Sezgin, I Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Coronary vasospasm in heart transplant recipients occurs through various mechanisms. It has been linked to allograft rejection and coronary vasculopathy, which can result in mortality during follow-up. Here, we investigated the prevalence of coronary vasospasm among heart transplant recipients undergoing surveillance coronary angiography procedures. MATERIALS AND METHODS: This study was prospectively performed at Başkent University Faculty of Medicine by retrospectively analyzing medical information of patients who underwent bicaval heart transplant between 2003 and 2016 and subsequently had coronary angiography to rule out allograft vasculopathy...
March 2018: Experimental and Clinical Transplantation
Marianne C Jacobsen, Maria D I Manunta, Emma S Pincott, Matthew Fenton, Gavin L Simpson, Nigel J Klein, Michael Burch
BACKGROUND: Cytomegalovirus (CMV) infection is implicated in endothelial dysfunction and graft damage after pediatric heart transplantation. CMV specific immune responses are thought to be necessary for CMV viral control but there is little data in pediatric heart transplantation. METHODS: We studied 28 consecutive pediatric heart transplant recipients for 1-year posttransplant. CMV-specific T cells expressing IFN-γ, TNF-α and IL-2 in response to ex-vivo stimulation with CMV lysates or peptides were measured...
March 5, 2018: Transplantation
Marianne Yardley, Lars Gullestad, Kari Nytrøen
One of the most important prognostic factors in heart failure patients is physical capacity. Patients with very poor physical performance and otherwise eligible, may be listed as candidates for heart transplantation (HTx). After such surgery, life-long immunosuppression therapy is needed to prevent rejection of the new heart. The dark side of immunosuppression is the increased risk of infections, kidney failure, cancer and advanced atherosclerosis (cardiac allograft vasculopathy), with the two latter conditions as the main causes of later mortality...
February 24, 2018: World Journal of Transplantation
Gilles Benichou, Aurore Prunevieille
No abstract text is available yet for this article.
March 5, 2018: American Journal of Transplantation
Anne I Dipchand
Pediatric heart transplantation is standard of care for children with end-stage heart failure. The diverse age range, diagnoses, and practice variations continue to challenge the development of evidence-based practices and new technologies. Outcomes in the most recent era are excellent, especially with the more widespread use of ventricular assist devices (VADs). Waitlist mortality remains high and knowledge of risk factors for death while waiting and following transplantation contributes to decision-making around transplant candidacy and timing of listing...
January 2018: Annals of Cardiothoracic Surgery
Jessica G Y Luc, Jae Hwan Choi, Syed-Saif Abbas Rizvi, Kevin Phan, Ester Moncho Escrivà, Sinal Patel, Gordon R Reeves, Andrew J Boyle, John W Entwistle, Rohinton J Morris, H Todd Massey, Vakhtang Tchantchaleishvili
Background: Transplant coronary artery vasculopathy (TCAV) is the major cause of late allograft failure and death in heart transplant recipients. The aim of this systematic review was to examine the outcomes of percutaneous coronary interventions (PCIs) as compared to coronary artery bypass grafting (CABG) surgery in the management of TCAV. Our secondary objective was to compare the use and outcomes of drug eluting stents (DES) as compared to bare metal stents (BMS) in this patient population...
January 2018: Annals of Cardiothoracic Surgery
Nadia Bouabdallaoui, Pierre Demondion, Sylvestre Maréchaux, Shaida Varnous, Guillaume Lebreton, Frédéric Mouquet, Pascal Leprince
BACKGROUND: Peripartum cardiomyopathy is an idiopathic disorder defined by the occurrence of acute heart failure during late pregnancy or post-partum period in the absence of any other definable cause. Its clinical course is variable and severe cases might require heart transplantation. OBJECTIVE: To investigate long-term outcomes after heart transplantation (HT) for peripartum cardiomyopathy (PPCM). METHODS: Out of a single-center series of 1938 HT, 14 HT were performed for PPCM...
February 2018: Arquivos Brasileiros de Cardiologia
Mandy Langstraat, Kyra J S Musters, Olivier Manintveld, Marco Masetti, Luciano Potena
Cardiac allograft vasculopathy (CAV) remains one of the main long-term complications after heart transplantation. We performed a systematic review focused on articles published in the previous 6 years to reappraise the novel evidences supporting risk factors, pathology, prevention, and treatment of CAV. We identified a search string for a literature search on PubMed. We excluded articles specifically focused on diagnosis/biomarkers/imaging only or complications of other diseases. We included 98 studies out of our search...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
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