C A Labarrere1, D R Nelson, W P Faulk. 1. Methodist Research Institute, Clarian Health (Methodist, Indiana University, and Riley Hospitals), Indianapolis 46202, USA.
Abstract
PURPOSE: To determine whether fibrin deposition during the first month following cardiac transplantation predicts development of coronary artery disease and graft failure in cardiac allograft recipients. PATIENTS AND METHODS: We prospectively studied 121 consecutive adult patients who received cardiac transplants between 1988 and 1995. Serial endomyocardial biopsies obtained during the first month posttransplant (2.3 + 0.6 biopsies/patient) were studied immunohistochemically for fibrin deposits. Patients were followed up with annual angiograms (3.2 + 1.7/patient) evaluated with side-by-side comparisons for the presence and progression of coronary artery disease. RESULTS: All pretransplant biopsies were fibrin-negative; 60 allografts (50%) remained without fibrin, and 61 (50%) contained fibrin during the first posttransplant month. Of allografts with fibrin, 72% developed coronary artery disease, while 27% of allografts without fibrin developed the disease (P <0.001). Coronary artery disease was progressive in 61% of allografts with fibrin, and in 25% of allografts without fibrin (P <0.001). Graft failure was more frequent and time-to-graft-failure occurred earlier in patients whose allografts had fibrin during the first month after transplantation (P <0.001). CONCLUSIONS: Fibrin in biopsies during the first month after transplantation identifies patients at high risk for developing coronary artery disease or graft failure, thereby allowing the opportunity to initiate preventive procedures.
PURPOSE: To determine whether fibrin deposition during the first month following cardiac transplantation predicts development of coronary artery disease and graft failure in cardiac allograft recipients. PATIENTS AND METHODS: We prospectively studied 121 consecutive adult patients who received cardiac transplants between 1988 and 1995. Serial endomyocardial biopsies obtained during the first month posttransplant (2.3 + 0.6 biopsies/patient) were studied immunohistochemically for fibrin deposits. Patients were followed up with annual angiograms (3.2 + 1.7/patient) evaluated with side-by-side comparisons for the presence and progression of coronary artery disease. RESULTS: All pretransplant biopsies were fibrin-negative; 60 allografts (50%) remained without fibrin, and 61 (50%) contained fibrin during the first posttransplant month. Of allografts with fibrin, 72% developed coronary artery disease, while 27% of allografts without fibrin developed the disease (P <0.001). Coronary artery disease was progressive in 61% of allografts with fibrin, and in 25% of allografts without fibrin (P <0.001). Graft failure was more frequent and time-to-graft-failure occurred earlier in patients whose allografts had fibrin during the first month after transplantation (P <0.001). CONCLUSIONS: Fibrin in biopsies during the first month after transplantation identifies patients at high risk for developing coronary artery disease or graft failure, thereby allowing the opportunity to initiate preventive procedures.
Authors: Katerina Akassoglou; Ryan A Adams; Jan Bauer; Peter Mercado; Vivian Tseveleki; Hans Lassmann; Lesley Probert; Sidney Strickland Journal: Proc Natl Acad Sci U S A Date: 2004-04-19 Impact factor: 11.205
Authors: Ronald J Torry; Robert J Tomanek; Wei Zheng; Steven J Miller; Carlos A Labarrere; Donald S Torry Journal: J Heart Lung Transplant Date: 2009-02 Impact factor: 10.247
Authors: Raymond L Benza; Matthew A Cavender; Joseph Barchue; Jose A Tallaj; Robert C Bourge; James K Kirklin; Christopher S Coffey Journal: J Heart Lung Transplant Date: 2007-05 Impact factor: 10.247
Authors: Carlos A Labarrere; John R Woods; James W Hardin; Beate R Jaeger; Marian Zembala; Mario C Deng; Ghassan S Kassab Journal: PLoS One Date: 2014-12-09 Impact factor: 3.240