CARDIAC ALLOGRAFT REJECTION LATE AFTER TRANSPLANTATION IS A RISK FACTOR FOR GRAFT CORONARY ARTERY DISEASE
Authors:
- 27 February 1998
- journal article
- research article
- Published by Wolters Kluwer Health in Transplantation
- Vol. 65 (4) , 538-543
Abstract
Background. Graft coronary artery disease (CAD) is an increasingly important problem during long-term survival after heart transplantation, but the importance of cellular rejection, in particular late after transplantation, remains undetermined. Methods and Results. We analyzed 492 coronary angiographies (967±705 days after transplantation; range, 49 days to 9.4 years) and 5201 endomyocardial biopsies(518±648 days after transplantation) from 156 patients (age, 47±11 years). Patients with angiographically detectable graft CAD had significantly more episodes of rejection requiring augmentation of immunosuppressive therapy (i.e., International Society of Heart and Lung Transplantation score≥3A) than those without graft CAD during the first(3.7±2.6 vs. 2.2±2.0, PPPPP40 years (OR=2.97,PPP. Conclusion. Rejection requiring augmentation of immunosuppression early and late after transplantation is an independent risk factor for the development of angiographically detectable graft CAD. Hence, the search for and treatment of moderate or severe rejection seems to be prudent even late after transplantation.Keywords
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