Related Experiment Video
Updated: Aug 19, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Are heart-lung transplant recipients protected from developing transplant coronary artery disease? A case-matched
1Division of Cardiovascular Medicine, Stanford University School of Medicine, CA 94305, USA.
Insights
Heart-lung transplant recipients show significantly less transplant coronary artery disease than heart transplant recipients. This finding suggests a lower risk of accelerated coronary artery disease in heart-lung transplant patients.
Area of Science:
- Cardiology
- Transplant Medicine
- Vascular Biology
Background:
- Accelerated coronary artery disease (CAD) is a primary cause of mortality in heart transplant recipients.
- Coronary artery disease does not appear to significantly impact clinical outcomes in heart-lung transplant recipients.
Purpose of the Study:
- To compare the incidence and severity of transplant coronary artery disease (Tx-CAD) between heart-lung transplant (HLT) and heart transplant (HT) recipients.
- To determine if Tx-CAD is less prevalent and severe in HLT recipients compared to HT recipients using intracoronary ultrasound.
Main Methods:
- Intracoronary ultrasound imaging of the left anterior descending coronary artery was performed in 22 HLT recipients and 22 case-matched HT recipients.
- Measurements included mean intimal area, intimal index, and Stanford class.
- Comparison focused on the incidence of at least moderate disease (Stanford class ≥ 3).
Main Results:
- HLT recipients exhibited significantly lower mean intimal area (1.6 vs. 3.8 mm²), intimal index (0.07 vs. 0.22), and Stanford class (1.7 vs. 2.7).
- The incidence of moderate to severe disease (Stanford class ≥ 3) was substantially lower in HLT recipients (14% vs. 45%).
Conclusions:
- The incidence and severity of transplant-associated coronary artery disease are considerably lower in patients who have undergone heart-lung transplantation compared to those who received a heart transplant alone.
Background:
Accelerated coronary artery disease is a major cause of mortality in heart transplant recipients; however, it does not appear to play a major role in the clinical outcome of heart-lung transplant recipients. The purpose of this study was to determine whether the incidence and severity of transplant coronary artery disease as detected by intracoronary ultrasound in heart-lung transplant recipients are less than those encountered in heart transplant recipients.
Methods And Results:
We studied the left anterior descending coronary artery with the use of intracoronary ultrasound imaging in 22 heart-lung transplant recipients at the time of their routine annual coronary angiogram. Twenty-two heart transplant recipients were case matched for number of years after transplant at ultrasound study, recipient age, donor age, and diagnosis of nonischemic cardiomyopathy. Mean intimal area, intimal index, Stanford class, and incidence of at least moderate disease (Stanford class > or = 3) were measured and calculated in each group and then compared between the two groups. Mean intimal area (1.6 +/- 2.5 versus 3.8 +/- 2.8 mm2), mean intimal index (0.07 +/- 0.10 versus 0.22 +/- 0.14), mean Stanford class (1.7 +/- 1.0 versus 2.7 +/- 1.2), and incidence of Stanford class > or = 3 (14% versus 45%) were significantly lower in the heart-lung transplant recipient group.
Conclusions:
The incidence and severity of transplant coronary artery disease are much less in patients receiving heart-lung transplants than in those receiving heart transplants alone.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:28Kidney Transplant I: Introduction