OBJECTIVES: This study sought to evaluate the influence of donor lesions on the development of cardiac allograft vasculopathy and outcomes in heart transplant recipients. BACKGROUND: After orthotopic heart transplantation (OHT), coronary artery narrowing occurs as a combination of pre-existing donor lesions and new lesions that develop as a result of cardiac allograft vasculopathy. METHODS: Intravascular ultrasound (IVUS) studies were performed in 301 recipients at 1.3 +/- 0.6 months and again at 12.2 +/- 0.8 months after OHT. Additional IVUS studies were performed in 90 patients at two and three years of follow-up. Sites at baseline with maximum intimal thickness > or =0.5 mm were defined as pre-existing donor lesions. The angiographic diagnosis of transplant coronary artery disease (TCAD) was defined as a new > or =50% diameter narrowing of a major epicardial vessel. RESULTS: Donor lesions were present in 30% of the hearts. By IVUS, sites with donor lesions did not have a greater increase in intimal area compared with sites without donor lesions. Angiographically, the incidence of TCAD up to three years after transplantation was higher in recipients with donor lesions than in recipients without donor lesions (25% vs. 4%, p < 0.001). However, the three-year mortality rate was similar between recipients with or without donor lesions (4.5% vs. 5.2%, p = 1.0). CONCLUSIONS: Pre-existing donor lesions do not act as a nidus for accelerating the progression of intimal hyperplasia. However, patients with donor lesions have a higher incidence of angiographic TCAD. Donor lesions do not affect the long-term survival of patients with OHT up to three years.
OBJECTIVES: This study sought to evaluate the influence of donor lesions on the development of cardiac allograft vasculopathy and outcomes in heart transplant recipients. BACKGROUND: After orthotopic heart transplantation (OHT), coronary artery narrowing occurs as a combination of pre-existing donor lesions and new lesions that develop as a result of cardiac allograft vasculopathy. METHODS: Intravascular ultrasound (IVUS) studies were performed in 301 recipients at 1.3 +/- 0.6 months and again at 12.2 +/- 0.8 months after OHT. Additional IVUS studies were performed in 90 patients at two and three years of follow-up. Sites at baseline with maximum intimal thickness > or =0.5 mm were defined as pre-existing donor lesions. The angiographic diagnosis of transplant coronary artery disease (TCAD) was defined as a new > or =50% diameter narrowing of a major epicardial vessel. RESULTS:Donor lesions were present in 30% of the hearts. By IVUS, sites with donor lesions did not have a greater increase in intimal area compared with sites without donor lesions. Angiographically, the incidence of TCAD up to three years after transplantation was higher in recipients with donor lesions than in recipients without donor lesions (25% vs. 4%, p < 0.001). However, the three-year mortality rate was similar between recipients with or without donor lesions (4.5% vs. 5.2%, p = 1.0). CONCLUSIONS: Pre-existing donor lesions do not act as a nidus for accelerating the progression of intimal hyperplasia. However, patients with donor lesions have a higher incidence of angiographic TCAD. Donor lesions do not affect the long-term survival of patients with OHT up to three years.
Authors: Jung-Min Ahn; Frederik M Zimmermann; Satish Arora; Ole-Geir Solberg; Oskar Angerås; Katrine Rolid; Muzammil Rafique; Lars Aaberge; Kristjan Karason; Kozo Okada; Helen Luikart; Kiran K Khush; Yasuhiro Honda; Nico H J Pijls; Sang Eun Lee; Jae-Joong Kim; Seung-Jung Park; Lars Gullestad; William F Fearon Journal: Eur Heart J Date: 2021-12-21 Impact factor: 35.855
Authors: Kozo Okada; William F Fearon; Helen Luikart; Hideki Kitahara; Kyuhachi Otagiri; Shigemitsu Tanaka; Takumi Kimura; Paul G Yock; Peter J Fitzgerald; Alan C Yeung; Hannah A Valantine; Kiran K Khush; Yasuhiro Honda Journal: J Am Coll Cardiol Date: 2016-07-26 Impact factor: 24.094
Authors: Bendix R Slegtenhorst; Frank J M F Dor; Abdala Elkhal; Hector Rodriguez; Xiaoyong Yang; Karoline Edtinger; Markus Quante; Anita S Chong; Stefan G Tullius Journal: Transplantation Date: 2014-06-15 Impact factor: 4.939
Authors: Daniel Höfer; Arezu Aliabadi; Christian Ebner; Christoph Hörmann; Stephane Mahr; Regina Mascherbauer; Gerhard Pölzl; Albert Reiter; Andrä Wasler; Thomas Weber; Michael Zink; Andreas Zuckermann; Herwig Antretter Journal: Wien Klin Wochenschr Date: 2010-07-16 Impact factor: 1.704