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Pathologic features in long-term cardiac allografts.

A M Pucci1, R D Forbes, M E Billingham

  • 1Department of Pathology, Pavia University, Italy.

The Journal of Heart Transplantation
|July 1, 1990
PubMed
Summary
This summary is machine-generated.

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Long-term heart transplant survival shows graft coronary artery disease resembling natural atherosclerosis, not typical graft disease. No tested factors predicted graft survival or disease progression.

Area of Science:

  • Cardiology
  • Transplantation Immunology
  • Pathology

Background:

  • Orthotopic heart transplantation is a life-saving procedure.
  • Graft coronary artery disease (GCAD) is a major cause of late graft failure.
  • Understanding the pathology of GCAD in long-term survivors is crucial.

Purpose of the Study:

  • To compare the pathologic conditions of coronary arteries in long-term heart transplant survivors (11-17 years) versus short-term survivors (2 years).
  • To identify factors correlating with graft survival and disease in heart transplant recipients.

Main Methods:

  • Comparative pathologic analysis of coronary arteries from six long-term and six short-term heart transplant survivors.
  • Matching of recipient/donor age and sex, and immunosuppressive therapy (azathioprine and prednisone).

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  • Investigation of ischemic time, HLA typing, rejection episodes, lipid profiles, and coronary angiograms.

    • Main Results:

    • Graft coronary disease was prevalent (10/12 cases) and a cause of graft failure (8/12).
    • Long-term survivors exhibited coronary artery pathology resembling natural atherosclerosis, distinct from the concentric GCAD seen in short-term survivors.
    • No investigated parameters (ischemic time, HLA, rejection, lipids, angiograms) correlated with graft survival or disease.

    Conclusions:

    • The histopathologic features of coronary artery disease differ between long-term and short-term heart transplant survivors.
    • The distinct pathology in long-term survivors suggests a different disease process than typical GCAD.
    • Current investigated factors are insufficient for predicting graft disease and survival in heart transplant recipients.