Cardiac Allograft Vasculopathy: Still a Challenge after Cardiac Transplantation
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".
Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 253
Special Issue Editor
Special Issue Information
Dear Colleagues,
Cardiac allograft vasculopathy (CAV) still remains one of the major challenges leading to graft failure after cardiac transplantation, and it cannot be prevented by standard immunosuppressants. Almost half of the recipients develop CAV within 10 years post-transplant. The underlying mechanisms are ongoing immunological events mainly induced by HLA-mismatch, rejection episodes, the presence of donor specific antibodies (DSA), and antibody mediated rejection (AMR) causing chronic vascular inflammation. Additionally, classical cardiovascular risk factors, for example, hypertension and dyslipidemia, as well as circumstances like donor age, organ preservation techniques, the ischemia-reperfusion injury, and worth mentioning cytomegalovirus infections, maintain the inflammation state that results in diffuse and concentric vessel lesions. All these factors provoke fibro-proliferative changes in the transplant vessels affecting both epicardial coronary arteries and the microvessels. The diffuse manifestation of these vascular lesions combined with late development of clinical symptoms hampers CAV diagnosis. Nevertheless, advanced consensus documents with uniform criteria for grading CAV were published so clinical studies became comparable. Moreover, further findings from animal models, the forward development of immunosuppression regimen, and numerous concepts of noninvasive imaging techniques have resulted in numerous clinical trials with the hope of preventing the development of cardiac allograft vasculopathy in the future.
Prof. Dr. Michael WeyandGuest Editor
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Keywords
- Cardiac allograft vasculopathy (CAV)
- Chronic rejection in kidney Tx
- Chronic rejection in liver Tx
- Chronic rejection in lung Tx
- Differences in organ appearances
- Animal models in CAV
- Retransplantation for CAV
- Diagnosis of late CAV: biopsy or other measures
- Importance of IVUS or OCT?
- MRI or CCT in CAV
- Tolerance in solid organ transplantation
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