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Cardiac allograft vasculopathy

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https://www.readbyqxmd.com/read/29146891/heart-transplantation-and-risk-of-cardiac-vasculopathy-development-what-factors-are-important
#1
Małgorzata Sobieszczańska-Małek, Jerzy Korewicki, Krzysztof Komuda, Małgorzata Karczmarz, Sylwia Szymańska, Alicja Cicha-Mikołajczyk, Paweł Bekta, Adam Parulski, Maciej Pronicki, Wiesława Grajkowska, Grzegorz Małek, Przemysław Leszek, Maria Kaczorowska, Mariusz Kuśmierczyk, Tomasz Zieliński
BACKGROUND The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL AND METHODS There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest)...
November 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29138760/cardiac-surgery-after-heart-transplantation-elective-operation-or-last-exit-strategy
#2
Johannes Goekler, Andreas Zuckermann, Emilio Osorio, Faris F Brkic, Keziban Uyanik-Uenal, Guenther Laufer, Arezu Aliabadi-Zuckermann
Background: Because of improved long-term survival after heart transplantation (HTx), late graft pathologies such as valvular disease or cardiac allograft vasculopathy (CAV) might need surgical intervention to enhance longer survival and ensure quality of life. To this date, there exist no guidelines for indication of cardiac surgery other than retransplantation after HTx. Methods: In this retrospective, single-center study, we evaluated patients who underwent cardiac surgery after HTx at our institution...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29128426/detection-of-early-changes-in-the-coronary-artery-microstructure-after-heart-transplantation-a-prospective-optical-coherence-tomography-study
#3
Tor Skibsted Clemmensen, Niels Ramsing Holm, Hans Eiskjær, Lars Jakobsen, Katrine Berg, Omeed Neghabat, Brian Bridal Løgstrup, Evald Høj Christiansen, Jouke Dijkstra, Christian Juhl Terkelsen, Michael Maeng, Steen Hvitfeldt Poulsen
BACKGROUND: Optical coherence tomography (OCT) enables in-vivo cardiac allograft vasculopathy (CAV) microstructure characterization. Early coronary artery microstructure changes after heart transplantation (HTx) may provide valuable mechanistic information regarding CAV development. Our in this study was to describe and characterize changes in the coronary artery microstructure during the first year after HTx using serial OCT scans. METHODS: Twenty-six patients were enrolled at routine baseline coronary angiography 3 months after HTx...
October 23, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29116562/prediction-of-long-term-%C3%A2-10%C3%A2-year-cardiovascular-outcomes-in-heart-transplant-recipients-value-of-stress-technetium-99m-tetrofosmin-myocardial-perfusion-imaging
#4
Jesse F Veenis, Hendrik J Boiten, Jan C van den Berge, Kadir Caliskan, Alex P W M Maat, Roelf Valkema, Alina A Constantinescu, Olivier C Manintveld, Felix Zijlstra, Ron T van Domburg, Arend F L Schinkel
BACKGROUND: Myocardial perfusion imaging (MPI) using single-photon emission computed tomography (SPECT) is useful in the evaluation of cardiac allograft vasculopathy (CAV) in heart transplant (HTx) recipients. The current study evaluated the long-term prognostic value of stress SPECT MPI for predicting all-cause mortality and cardiac events in HTx recipients. METHODS: The study population consisted of 166 HTx recipients (mean age 54 ± 10 years, 84% male) who underwent exercise or dobutamine stress (99m)Tc-tetrofosmin SPECT MPI for the assessment of CAV...
November 7, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29116561/myocardial-perfusion-imaging-for-cardiac-allograft-vasculopathy-assessment-evidence-grows-but-questions-remain
#5
EDITORIAL
Deepak Acharya, Indranee Rajapreyar
No abstract text is available yet for this article.
November 7, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29110796/long-term-outcomes-and-management-of-the-heart-transplant-recipient
#6
REVIEW
Sharon L McCartney, Chetan Patel, J Mauricio Del Rio
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29103660/the-effect-of-clinical-variables-on-distress-and-depressive-symptoms-among-heart-transplant-recipients
#7
Irena Milaniak, Ewa Wilczek-Rużyczka, Karol Wierzbicki, Anna Kędziora, Piotr Przybyłowski
BACKGROUND: Heart transplantation (HTx) is the standard treatment for end-stage cardiomyopathy and coronary artery disease. Although major improvements have been made in the prevention and treatment of acute graft rejection, comorbidities still limit the long-term survival of heart transplant recipients. The risk of poor outcome, such us major health status aggravation and death, can stimulate the occurrence of depression and stress in this population. The aim of this study was to determine the impact of comorbidities on depressive symptoms and distress among heart transplant recipients...
November 2, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29097449/genetic-and-functional-profiling-of-cd16-dependent-natural-killer-activation-identifies-patients-at-higher-risk-of-cardiac-allograft-vasculopathy
#8
Pascale Paul, Christophe Picard, Emmanuelle Sampol, Luc Lyonnet, Julie Di Cristofaro, Louise Paul-Delvaux, Guillaume Lano, Corinne Nicolino Brunet, Eleonore Ravis, Frederic Collart, Francoise Dignat George, Bertrand Dussol, Florence Sabatier, Annick Mouly Bandini
Background -Cardiac transplantation is an effective therapy for end-stage heart failure. As cardiac allograft vasculopathy (CAV) is the major cause of late mortality after heart transplant (HT), there is a need to identify markers that reflect inflammatory or cytotoxic immune mechanisms contributing to its onset. Non-invasive and early stratification of patients at risk remains a challenge for adapting individualized therapy. The CD16 (Fc-gamma receptor 3A, FCGR3A) receptor was recently identified as a major determinant of antibody-mediated natural killer (NK) cell activation in HT biopsies; however, little is known about the role of CD16 in promoting allograft vasculopathy...
November 2, 2017: Circulation
https://www.readbyqxmd.com/read/29093713/cardiac-non-human-leukocyte-antigen-identification-techniques-and-troubles
#9
REVIEW
Katherine V Gates, Naveen L Pereira, Leigh G Griffiths
Historically efforts have focused on the human leukocyte antigen (HLA) as the major cause for acute and chronic rejection following cardiac transplantation. However, rising evidence indicates that non-HLA antibodies can be both primary initiators and modifiers of antibody-mediated rejection (AMR) and cardiac allograft vasculopathy (CAV). The purpose of this review is to assess currently available technologies for non-HLA identification and leveraging such responses toward antibody quantification. Several techniques have been used to identify antigenic determinants of recipient graft-specific non-HLA humoral immune responses, but each comes with its own set of benefits and caveats...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29092871/heart-transplant-outcomes-in-patients-with-pretransplant-diabetes-mellitus
#10
Anne Jalowiec, Kathleen L Grady, Connie White-Williams
BACKGROUND: Findings on outcomes of heart transplant patients who had diabetes mellitus before transplant are conflicting. OBJECTIVE: To compare survival, hospitalization, and complications in heart transplant recipients during the first 3 years after surgery in recipients with or without diabetes mellitus before transplant. METHODS: Of 347 recipients, 64 were diabetic (35.9% taking insulin; mean age 56 years; 17.2% females; 12.5% minorities) and 283 were not (mean age 51 years; 20...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29091000/image-quality-of-prospectively-ecg-triggered-coronary-ct-angiography-in-heart-transplant-recipients
#11
Andrea Bartykowszki, Márton Kolossváry, Ádám Levente Jermendy, Júlia Karády, Bálint Szilveszter, Mihály Károlyi, Orsolya Balogh, Balázs Sax, Béla Merkely, Pál Maurovich-Horvat
OBJECTIVE: Cardiac allograft vasculopathy (CAV) is among the top causes of death 1 year after heart transplantation (HTx). Coronary CT angiography (CTA) is a potential alternative to invasive imaging in the diagnosis of CAV. However, the higher heart rate (HR) of HTx recipients prompts the use of retrospective ECG-gating, which is associated with higher radiation dose, a major concern in this patient population. Therefore, we sought to evaluate the feasibility and image quality of low-radiation-dose prospectively ECG-triggered coronary CTA in HTx recipients...
November 1, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29083554/accelerated-cardiac-allograft-vasculopathy-after-pediatric-heart-transplantation
#12
EDITORIAL
Jenny E Zablah, Melanie D Everitt, Neil Wilson
No abstract text is available yet for this article.
November 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29055600/prevalence-of-polyreactive-innate-clones-among-graft-infiltrating-b-cells-in-human-cardiac-allograft-vasculopathy
#13
Debanjana Chatterjee, Carolina Moore, Baoshan Gao, Kevin J Clerkin, Sarah B See, David Shaked, Kortney Rogers, Sarah Nunez, Yokarla Veras, Linda Addonizio, Michael M Givertz, Yoshifumi Naka, Donna Mancini, Rodica Vasilescu, Charles Marboe, Susan Restaino, Joren C Madsen, Emmanuel Zorn
BACKGROUND: Cardiac allograft vasculopathy (CAV) has been associated with graft-infiltrating B cells, although their characteristics are still unclear. In this study we examined the frequency, localization and reactivity profile of graft-infiltrating B cells to determine their contribution to the pathophysiology of CAV. METHODS: B cells, plasma cells and macrophages were examined by immunohistochemistry in 56 allografts with CAV, 49 native failed hearts and 25 autopsy specimens...
September 28, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29045076/outside-in-hla-class-i-signaling-regulates-icam-1-clustering-and-endothelial-monocyte-interactions-via-mtor-in-transplant-antibody-mediated-rejection
#14
Sahar Salehi, Rebecca A Sosa, Yi-Ping Jin, Shoichi Kageyama, Michael C Fishbein, Enrique Rozengurt, Jerzy W Kupiec-Weglinski, Elaine F Reed
Antibody-mediated rejection (AMR) resulting in transplant allograft vasculopathy (TAV) is the major obstacle for long-term survival of solid organ transplants. AMR is caused by donor-specific antibodies to HLA which contribute to TAV by initiating outside-in signaling transduction pathways that elicit monocyte recruitment to activated endothelium. Mechanistic target of rapamycin (mTOR) inhibitors can attenuate TAV; therefore, we sought to understand the mechanistic underpinnings of mTOR signaling in HLA class I Ab-mediated endothelial cell activation and monocyte recruitment...
October 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28990263/early-aspirin-initiation-following-heart-transplantation-is-associated-with-reduced-risk-of-allograft-vasculopathy-during-long-term-follow-up
#15
Yael Peled, Jacob Lavee, Eugenia Raichlin, Moshe Katz, Michael Arad, Yigal Kassif, Amir Peled, Elad Asher, Dan Elian, Yedael Har-Zahav, Nir Shlomo, Dov Freimark, Ilan Goldenberg, Robert Klempfner
AIM: Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality after heart transplantation (HT). Enhanced platelet reactivity is a contributing factor. We aimed to investigate the association between early initiation of aspirin therapy post-HT and the 15-year risk of the development of CAV. METHODS: We studied 206 patients who underwent HT between 1991and 2016. Multivariate Cox proportional hazards regression modeling was employed to evaluate the association between early aspirin initiation and the long-term risk of CAV...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28988608/routine-c4d-immunohistochemistry-in-cardiac-allografts-long-term-outcomes
#16
Aliya N Husain, Kamran M Mirza, Savitri E Fedson
BACKGROUND: In the past decade, C4d has emerged as a potential marker for antibody-mediated rejection (AMR); however, evidence on its use as a prognostic tool has been controversial. Although the International Society for Heart and Lung Transplantation guideline recommends early routine surveillance of C4d in heart transplantation, there is no consensus on its value in the pathologic assessment of AMR. Herein we present a correlation analysis of C4d immunoreactivity in endomyocardial biopsies with clinical cardiac dysfunction, cellular rejection, human leukocyte antigen (HLA) status, cardiac allograft vasculopathy (CAV) and death...
September 14, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28969528/intrapatient-variability-in-tacrolimus-exposure-does-not-predict-the-development-of-cardiac-allograft-vasculopathy-after-heart-transplant
#17
Nauras Shuker, Rachida Bouamar, Dennis A Hesselink, Teun van Gelder, Kadir Caliskan, Olivier C Manintveld, Aggie H Balk, Alina A Constantinescu
OBJECTIVE: A high intrapatient variability in tacrolimus exposure is associated with poor long-term outcomes after kidney transplant. We hypothesized that a high intrapatient variability of tacrolimus exposure after heart transplant may be associated with cardiac allograft vasculopathy as a determinant of long-term survival of heart transplant recipients. MATERIALS AND METHODS: Eighty-six heart transplant recipients were included. Patients underwent coronary angiography at years 1 and 4 after transplant and were divided according to low and high intrapatient variability of tacrolimus exposure, with the median variability as cut-off...
September 30, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28923645/comparison-of-segmental-versus-longitudinal-intravascular-ultrasound-analysis-for-pediatric-cardiac-allograft-vasculopathy
#18
M A Kuhn, M Burch, R E Chinnock, M J Fenton
Intravascular ultrasound (IVUS) has been routinely used in some centers to investigate cardiac allograft vasculopathy in pediatric heart transplant recipients. We present an alternative method using more sophisticated imaging software. This study presents a comparison of this method with an established standard method. All patients who had IVUS performed in 2014 were retrospectively evaluated. The standard technique consisted of analysis of 10 operator-selected segments along the vessel. Each study was re-evaluated using a longitudinal technique, taken at every third cardiac cycle, along the entire vessel...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28885488/complement-c1q-binding-de-novo-donor-specific-antibodies-and-cardiac-allograft-vasculopathy-in-pediatric-heart-transplant-recipients
#19
Bibhuti B Das, Chantale Lacelle, Song Zhang, Ang Gao, David Fixler
BACKGROUND: We hypothesized C1q binding de novo donor specific antibody (DSA) after heart transplant (HT) is a higher risk for development of coronary artery vasculopathy (CAV) in children. METHODS: A retrospective analysis of 127 pediatric heart transplant (HT) recipients transplanted between January 2005 and December 2014 was used to determine complement (C1q)-binding de novo DSA on the outcomes of HT and the ability of the C1q assay to predict CAV development...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28865557/multimodality-noninvasive-imaging-in-the-monitoring-of-pediatric-heart-transplantation
#20
REVIEW
Steven J Kindel, Hao H Hsu, Tarique Hussain, Jonathan N Johnson, Colin J McMahon, Shelby Kutty
Orthotopic heart transplantation is a well-established and effective therapeutic option for children with end-stage heart failure. Multiple modalities, including noninvasive cardiac imaging, cardiac catheterization, angiography, and endomyocardial biopsy, are helpful to monitor these patients for graft dysfunction, rejection, and vasculopathy. Because of morbidities associated with invasive monitoring, noninvasive imaging plays a key role in the surveillance and evaluation of symptoms in pediatric transplant recipients...
September 2017: Journal of the American Society of Echocardiography
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