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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Impaired Right Ventricular Function in Heart Transplant Rejection.

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Moderate cellular rejection in heart transplant recipients is linked to reduced right ventricular function, detectable by echocardiography. This highlights echocardiographic parameters as potential screening tools for rejection.

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Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Echocardiography

Background:

  • Screening for complications improves survival rates in heart transplant (HTx) recipients.
  • Early detection of rejection is crucial for long-term graft survival.

Purpose of the Study:

  • To determine if changes in left ventricular (LV) and right ventricular (RV) global longitudinal strain (GLS) correlate with cellular rejection in HTx patients.
  • To investigate the utility of echocardiographic parameters in identifying cellular rejection episodes.

Main Methods:

  • Retrospective analysis of 19 HTx patients with 170 paired biopsies and echocardiograms.
  • Comparison of echocardiographic findings between patients with no/mild rejection (0R/1R) and moderate rejection (2R).
  • Evaluation of LV and RV systolic function using conventional parameters and GLS.

Main Results:

  • Patients with moderate rejection (2R) showed increased LV posterior wall thickness, E/e', and E/A ratios compared to those with 0R/1R rejection.
  • No significant difference in LV systolic function was observed between groups.
  • RV systolic function was significantly reduced in the 2R group, evidenced by lower TAPSE, S wave, and RV fractional area change.
  • RV GLS was significantly reduced in the 2R group (-20.6 ± 4.9%) compared to the 0R/1R group (-23.0 ± 4.4%).

Conclusions:

  • Moderate acute cellular rejection in HTx recipients is associated with RV systolic dysfunction, detectable by RV strain and conventional echocardiography.
  • Echocardiographic parameters, particularly RV strain, show promise as non-invasive screening tools for cellular rejection.