Transplant vasculopathy

Transplant vasculopathy constitutes the major impediment to long-term survival in heart transplant recipients. Within the "response to immune injury" paradigm, it can best be understood as the resultant of an orchestrated recipient immune response to the initial allogenic stimulus by graft...

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Bibliographic Details
Published in:Herz 1998-05, Vol.23 (3), p.197-201
Main Authors: Deng, M C, Tjan, T D, Asfour, B, Roeder, N, Scheld, H H
Format: Article
Language:English
Subjects:
Animals
Coronary Disease - immunology
Cytokines
Cytokines - physiology
Endothelium
Endothelium, Vascular - immunology
Fibromuscular Dysplasia - immunology
Heart Transplantation - immunology
Humans
Immunity, Cellular - immunology
Isoantigens - immunology
Postoperative Complications - immunology
Risk Factors
Transplants & implants
Tunica Intima - immunology
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Summary:Transplant vasculopathy constitutes the major impediment to long-term survival in heart transplant recipients. Within the "response to immune injury" paradigm, it can best be understood as the resultant of an orchestrated recipient immune response to the initial allogenic stimulus by graft vascular endothelium. This response incorporates the elaboration of complex coordinated cytokine patterns and corresponding cell types including B-lymphocytes, T-helper1- and T-helper2-cells, cytotoxic T-cells, macrophages, and polymorphonuclear cells. These attack the alloantigenic vascular endothelium and lead, by complex cytokine signaling, to migration of donor smooth muscle cells from the media into the intima, associated with a switch from the contractile to a synthetic phenotype. In conjunction with recipient T-cells, macrophages, and lipids, the intimal fibroproliferative growth of the donor vessel is hereby initiated.
ISSN:0340-9937
1615-6692
DOI:10.1007/BF03044606