Cardiac allograft vasculopathy.
As the survival rates for cardiac transplant patients improve, the long-term complications of the procedure are becoming apparent. One such complication is a rapidly progressing form of coronary artery disease known as cardiac allograft vasculopathy (CAV). CAV is a major limiting factor in long-term graft survival. It is thought to develop immediately after transplantation, although initially it may be unrecognized because of a lack of sensitive screening techniques. It is estimated that 12% of cardiac transplant recipients will develop CAV each year after transplantation. Most researchers agree that CAV is primarily an immune-related response to transplantation. However, other factors such as hyperlipidemia and obesity have also been implicated as predictors of CAV. This article explores the pathophysiology, risk factors, detection, and treatment of CAV in the cardiac transplant population.
Pfeifer
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Nursing Service, Department of Veteran Affairs, Edward Hines, Jr. Hospital Hines, Illinois.
Collins
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D000959:Antihypertensive Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000628:therapy; D016207:Cytokines / Q000276:immunology; D003937:Diagnosis, Differential; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015994:Incidence; D010982:Platelet-Derived Growth Factor / Q000276:immunology; D012307:Risk Factors
D000959:Antihypertensive Agents; D000998:Antiviral Agents; D016207:Cytokines; D010982:Platelet-Derived Growth Factor