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Cardiac allograft vasculopathy

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https://www.readbyqxmd.com/read/28029575/use-of-sirolimus-in-pediatric-heart-transplant-patients-a-multi-institutional-study-from-the-pediatric-heart-transplant-study-group
#1
Joseph W Rossano, John L Jefferies, Elfriede Pahl, David C Naftel, Elizabeth Pruitt, Kathy Lupton, William J Dreyer, Richard Chinnock, Gerard Boyle, William T Mahle
BACKGROUND: Proliferation signal inhibitors, such as sirolimus, are increasingly used in solid-organ transplantation. However, limited data exist on sirolimus-treated pediatric patients. We aimed to describe sirolimus use in pediatric heart transplant patients and test the hypothesis that sirolimus use is associated with improved outcomes. METHODS: A retrospective review and propensity-matched analysis of the Pediatric Heart Transplant Study database was performed on patients undergoing primary heart transplantation from 2004 to 2013 with at least 1 year of follow-up comparing patients treated vs not treated with sirolimus at 1 year after transplant...
October 4, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27993641/as2553627-a-novel-jak-inhibitor-prevents-chronic-rejection-in-rat-cardiac-allografts
#2
Koji Nakamura, Masamichi Inami, Hiroki Morio, Kenji Okuma, Misato Ito, Takahisa Noto, Shohei Shirakami, Jun Hirose, Tatsuaki Morokata
Janus family kinases (JAKs) are essential molecules for cytokine responses and attractive targets for the treatment of transplant rejection and autoimmune diseases. Several JAK inhibitors have shown demonstrable effects on acute rejection in experimental cardiac transplant models. However, little is known about the potential benefits of JAK inhibitors on chronic rejection outcomes such as vasculopathy and fibrosis. Here, we examined the pharmacological profile of a novel JAK inhibitor, AS2553627, and explored its therapeutic potential in chronic rejection as well as acute rejection in a rat cardiac transplant model...
December 16, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27970210/tct-818-early-left-ventricular-dysfunction-is-associated-with-cardiac-allograft-vasculopathy-and-late-mortality-after-heart-transplantation
#3
Kozo Okada, Yasuhiro Honda, Helen Luikart, Paul Yock, Peter J Fitzgerald, Alan Yeung, Hannah Valantine, Kiran Khush, William Fearon
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969675/tct-328-coronary-stenting-in-cardiac-allograft-vasculopathy-a-single-center-experience
#4
Sara Casquero Dominguez, Monica Fernandez Quero, Diego Rangel-Sousa, Jose Maria Cubero, Luis Diaz de la Llera, Agustin Guisado Rasco, Manuel Villa Gil-Ortega
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969670/tct-323-predictors-of-clinical-outcome-and-subsequent-target-lesion-revascularization-after-percutaneous-coronary-procedures-with-drug-eluting-stents-and-everolimus-eluting-bioresorbable-scaffolds-for-cardiac-allograft-vasculopathy
#5
Valentina Vaccaro, Irene Maria Bossi, Margherita D'Anna, Giacomo Piccalo, Maria Paola Caria, Giovanna Pedrazzini, Enrico Ammirati, Fabio Turazza, Fabrizio Oliva, Andrea Rueda
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27935648/cardiac-allograft-vasculopathy-after-heart-transplantation-is-it-really-ominous
#6
Ju Yong Lim, Sung Ho Jung, Min Seok Kim, Jeong-Jun Park, Tae-Jin Yun, Jae Joong Kim, Jae Won Lee
OBJECTIVES: Cardiac allograft vasculopathy (CAV) remains a major impediment to long-term survival after heart transplantation (HT). We investigated the incidence, disease course, and risk factors for CAV. METHODS: Among 399 patients who underwent HT between November 1992 and July 2014, 297 survivors were reviewed. Endpoints were CAV development and the composite outcome of death or re-HT. RESULTS: During 5.6±5.2 years, CAV was detected in 54 patients; 45 (83...
December 9, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27932139/de-novo-anti-hla-antibodies-after-heart-transplantation-are-associated-with-adverse-events-in-the-long-term-follow-up-of-cardiac-transplant-recipients
#7
E Solé-González, S Mirabet, V Brossa, L López-López, M Rivas-Lasarte, H Capellades-Olivella, A J Ginel-Iglesias, J Martorell-Pons, E Roig
BACKGROUND AND OBJECTIVES: Long-term morbidity and mortality after heart transplantation (HTx) remain very high. Several reports have suggested that anti-HLA antibodies (anti-HLA-AB) detected after HTx might be associated with poor survival, but the implication of isolated anti-HLA-AB is still under debate. The aim of the study was to analyze the incidence of de novo anti-HLA-AB and whether they are associated with adverse events after HTx. METHODS: This retrospective study analyzed the presence of anti-HLA-AB assessed by fluorimetry (Luminex) and quantified by a single-antigen bead assay in 119 HTx patients...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27916323/donor-specific-anti-hla-antibodies-with-antibody-mediated-rejection-and-long-term-outcomes-following-heart-transplantation
#8
Kevin J Clerkin, Maryjane A Farr, Susan W Restaino, Emmanuel Zorn, Farhana Latif, Elena R Vasilescu, Charles C Marboe, Paolo C Colombo, Donna M Mancini
BACKGROUND: Donor-specific anti-HLA antibodies (DSA) are common after heart transplantation and are associated with rejection, cardiac allograft vasculopathy, and mortality. A noninvasive diagnostic test for pathologic antibody-mediated rejection (pAMR) does not exist. METHODS: From January 1, 2010, through August 31, 2013, 221 consecutive adult patients underwent heart transplantation and were followed through October 1, 2015. The primary objective was to determine whether the presence of DSA could detect AMR at the time of pathologic diagnosis...
November 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27898462/recent-advances-in-allograft-vasculopathy
#9
Jonathan Merola, Daniel D Jane-Wit, Jordan S Pober
PURPOSE OF REVIEW: Despite considerable advances in controlling acute rejection, the longevity of cardiac and renal allografts remains significantly limited by chronic rejection in the form of allograft vasculopathy. This review discusses recently reported mechanistic insights of allograft vasculopathy pathogenesis as well as recent clinical evaluations of new therapeutic approaches. RECENT FINDINGS: Although adaptive immunity is the major driver of allograft vasculopathy, natural killer cells mediate vasculopathic changes in a transplanted mouse heart following treatment with donor-specific antibody (DSA)...
February 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27893615/biomarkers-for-cardiac-allograft-vasculopathy-still-searching-after-all-these-years
#10
Evan P Kransdorf, Jon A Kobashigawa
No abstract text is available yet for this article.
January 2017: Transplantation
https://www.readbyqxmd.com/read/27876281/post-transplant-surveillance-for-acute-rejection-and-allograft-vasculopathy-by-echocardiography-usefulness-of-myocardial-velocity-and-deformation-imaging
#11
Michael Dandel, Roland Hetzer
Diagnosing and monitoring acute rejection (AR) and cardiac allograft vasculopathy (CAV) is essential for graft and transplant patient survival and, consequently, a major objective for heart transplant patient surveillance. Because functionally relevant CAV can arise and progress without clinical symptoms and sub-clinical ARs can facilitate the development of CAV, standard surveillance of AR and CAV includes routine endomyocardial biopsy (EMB) and coronary angiography (CA) screenings at pre-defined time intervals...
October 7, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27866017/safety-of-optical-coherence-tomography-in-pediatric-heart-transplant-patients
#12
Sarah M Ulrich, Anja Lehner, Julia Birnbaum, Stefanie Heckel, Nikolaus A Haas, Lale Hakami, Rene Schramm, Robert Dalla Pozza, Marcus Fischer, Rainer Kozlik-Feldmann
BACKGROUND: Cardiac allograft vasculopathy (CAV) is a crucial problem after heart transplantation, in adults as well as in children. CAV is the main risk factor for a reduced long-term graft survival. The early diagnosis and treatment of CAV is essential for a successful long-term preservation of the donor heart. However, asymptomatic progression of CAV and concentric hyperplasia of the coronary arteries may complicate the early diagnosis by conventional measures. Intravascular imaging, such as intravascular ultrasound and optical coherence tomography (OCT), enables the diagnosis of early stage CAV...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865734/vascular-endothelial-growth-factor-a-is-associated-with-the-subsequent-development-of-moderate-or-severe-cardiac-allograft-vasculopathy-in-pediatric-heart-transplant-recipients
#13
Kevin P Daly, Maria Stack, Michele F Eisenga, John F Keane, David Zurakowski, Elizabeth D Blume, David M Briscoe
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the leading cause of chronic allograft loss after pediatric heart transplantation. We hypothesized that biomarkers of endothelial injury and repair would predict CAV development in pediatric heart transplant recipients. METHODS: Blood was collected from pediatric heart transplant recipients at the time of routine annual coronary angiography, and the concentrations of 13 angiogenesis-related molecules were determined...
October 3, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27865004/long-term-effects-of-high-intensity-interval-training-in-heart-transplant-recipients-a-5-year-follow-up-study-of-a-randomized-controlled-trial
#14
Marianne Yardley, Lars Gullestad, Bjørn Bendz, Elisabeth Bjørkelund, Katrine Rolid, Satish Arora, Kari Nytrøen
BACKGROUND: Previous studies have demonstrated that high-intensity interval training (HIT) is superior to moderate-continuous exercise in general and in cardiovascular diseases. Recently, we also found HIT safe and efficient after heart transplantation (HTx). This study reports the 5-year long-term effects. DESIGN AND METHODS: Forty-one HTx patients who had completed the previous 12-month randomized controlled trial, comparing HIT intervention with usual care, were eligible...
January 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/27862968/the-xiiith-banff-conference-on-allograft-pathology-the-banff-2015-heart-meeting-report-improving-antibody-mediated-rejection-diagnostics-strengths-unmet-needs-and-future-directions
#15
P Bruneval, A Angelini, D Miller, L Potena, A Loupy, A Zeevi, E F Reed, D Dragun, N Reinsmoen, R N Smith, L West, S Tebutt, T Thum, M Haas, M Mengel, P Revelo, M Fedrigo, J P Duong Van Huyen, G J Berry
The 13th Banff Conference on Allograft Pathology was held in Vancouver, British Columbia, Canada from October 5 to 10, 2015. The cardiac session was devoted to current diagnostic issues in heart transplantation with a focus on antibody-mediated rejection (AMR) and small vessel arteriopathy. Specific topics included the strengths and limitations of the current rejection grading system, the central role of microvascular injury in AMR and approaches to semiquantitative assessment of histopathologic and immunophenotypic indicators, the role of AMR in the development of cardiac allograft vasculopathy, the important role of serologic antibody detection in the management of transplant recipients, and the potential application of new molecular approaches to the elucidation of the pathophysiology of AMR and potential for improving the current diagnostic system...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/27862865/long-term-clinical-and-angiographic-outcomes-of-percutanenous-coronary-intervention-with-everolimus-eluting-stents-for-the-treatment-of-cardiac-allograft-vasculopathy
#16
Richard Cheng, Christopher Vanichsarn, Jignesh K Patel, Jesse Currier, David H Chang, Michelle M Kittleson, Raj Makkar, Jon A Kobashigawa, Babak Azarbal
BACKGROUND: Percutaneous coronary intervention (PCI) with bare-metal and first-generation drug-eluting stents (DES) for cardiac allograft vasculopathy (CAV) is associated with unexpectedly high restenosis rates and target lesion revascularization (TLR). Long-term outcomes of stenting for CAV using second-generation everolimus-eluting stents (EES) are not established. OBJECTIVE: To evaluate clinical and angiographic outcomes of CAV stenting with EES. METHODS: Patients who underwent PCI with EES for CAV were studied...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27834759/current-expectations-for-cardiac-transplantation-in-patients-with-congenital-heart-disease
#17
James K Kirklin, Waldemar F Carlo, F Bennett Pearce
Congenital heart disease accounts for 40% of pediatric heart transplants and presents unique challenges to the transplant team. Suitability for transplantation is defined in part by degree of sensitization, pulmonary vascular resistance, and hepatic reserves. The incremental transplant risk for patients with congenital heart disease occurs within the first 3 months, after which survival is equivalent to transplantation for cardiomyopathy. Single ventricle with prior palliation, and especially the failing Fontan, carry the highest risk for transplantation and are least amenable to bridging with mechanical circulatory support...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27814596/diagnosis-of-cardiac-allograft-vasculopathy-challenges-and-opportunities
#18
Bhavesh Patel, Aashish Ahuja, Ghassan S Kassab, Carlos A Labarrere
Cardiac allograft vasculopathy (CAV) is one of the most common long-term complications in patients following heart transplantation. Because of its irreversible nature, early detection is essential to impact progression. Thus, imaging techniques play a crucial role in the diagnosis and subsequent treatment. Major advancements in imaging and analysis are required to overcome the limitations of current techniques. Coronary angiography which is the standard method, presents low sensitivity in detection, especially at an early stage...
January 1, 2017: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/27814594/cardiac-allograft-vasculopathy-microvascular-arteriolar-capillaries-capioles-and-survival
#19
Carlos A Labarrere, Beate R Jaeger, Ghassan S Kassab
Cardiac allograft vasculopathy (CAV) is a serious complication of heart transplantation in adults and children. Risk factors include human leukocyte antigen mismatches, number and duration of rejection episodes, type of immunosuppression, antibody-mediated rejection, hypertension, hyperlipidemia, obesity, smoking, diabetes, cytomegalovirus infection, mode of donor brain death, donor age and ischemia/reperfusion injury. Endothelial injury and dysfunction in CAV are characterized by changes in adhesion molecules and up-regulation of major histocompatibility class II antigens followed by endothelial activation of complement C4d...
January 1, 2017: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/27795988/sex-related-differences-in-the-risk-of-antibody-mediated-rejection-and-subsequent-allograft-vasculopathy-post-heart-transplantation-a-single-center-experience
#20
Avishay Grupper, Emilija M Nestorovic, Richard C Daly, Natasa M Milic, Lyle D Joyce, John M Stulak, David L Joyce, Brooks S Edwards, Naveen L Pereira, Sudhir S Kushwaha
BACKGROUND: Pregnancies may result in antibodies against HLA, a risk factor for antibody-mediated rejection (AMR) and subsequent cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). The aim of this study was to evaluate sex differences in the incidence of AMR events and subsequent risk of CAV among HTx recipients. METHODS: The study comprised 160 patients (51 [32%] women) who underwent HTx in 2008 to 2014. The cumulative effect of AMR events was calculated by AMR score (sum of myocardial biopsy grading divided by number of biopsies taken during 3 years post-HTx)...
October 2016: Transplantation Direct
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