Mechanisms of chronic cardiac allograft rejection

Chronic rejection in the form of cardiac allograft vasculopathy is one of the major factors that affects long-term graft and patient survival after heart transplantation. Whereas multiple factors contribute to the development of cardiac allograft vasculopathy, immunologic mechanisms play the predomi...

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Bibliographic Details
Published in:Texas Heart Institute journal 2013, Vol.40 (4), p.395-399
Main Authors: Costello, John P, Mohanakumar, Thalachallour, Nath, Dilip S
Format: Article
Language:English
Subjects:
Animals
Chronic Disease
Coronary Artery Disease - immunology
Coronary Artery Disease - prevention & control
Graft Rejection - immunology
Graft Rejection - prevention & control
Graft Survival
Heart Transplantation - adverse effects
Humans
Immunosuppressive Agents - therapeutic use
Review
Risk Factors
Time Factors
Treatment Outcome
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Summary:Chronic rejection in the form of cardiac allograft vasculopathy is one of the major factors that affects long-term graft and patient survival after heart transplantation. Whereas multiple factors contribute to the development of cardiac allograft vasculopathy, immunologic mechanisms play the predominant role in the chronic rejection process, because both alloimmune and autoimmune responses are causal factors. In addition, many nonimmune donor and recipient factors also affect the development of cardiac allograft vasculopathy, including hyperlipidemia, cytomegalovirus infection, baseline coronary artery disease, and the mechanism of brain death in the donor. Modern immunosuppression maintenance therapies have the potential to limit the development of cardiac allograft vasculopathy in the long term. Further research initiatives are needed to identify patient-specific immunosuppressive drug regimens and to elucidate factors that contribute to the chronic rejection of cardiac transplant allografts.
ISSN:0730-2347
1526-6702