Relationship of fibrin deposition in microvasculature to outcomes in cardiac transplantation.
The development of transplant coronary artery disease (CAD) is directly associated with outcome in cardiac transplantation. The relationship between microvascular fibrin deposition early after transplantation and subsequent development of transplant CAD is discussed in this article. In this article the presence of microvascular fibrin and its association with other prothrombogenic changes within the cardiac microvasculature, such as loss of vascular antithrombin, depletion of arteriolar tissue plasminogen activator, and presence of arterial and arteriolar endothelium activation, as well as changes in circulation associated with prothrombogenic changes that have predictive value for subsequent transplant outcome are presented and discussed. Novel therapeutic approaches that may prevent the development of transplant CAD and consequently affect outcome are considered.
Labarrere
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Methodist Research Institute, Clarian Health (Methodist, Indiana University, Riley Hospitals), Indianapolis 46202, USA.
D000818:Animals; D001779:Blood Coagulation Factors / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000378:metabolism; D003327:Coronary Disease / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D004730:Endothelium, Vascular / Q000378:metabolism; D005337:Fibrin / Q000378:metabolism*; D016027:Heart Transplantation / Q000009:adverse effects / Q000473:pathology*; D006801:Humans; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011379:Prognosis
D001779:Blood Coagulation Factors; D015815:Cell Adhesion Molecules; D005337:Fibrin