Cardiac allograft vasculopathy: current review and future research directions

Author:

Pober Jordan S1,Chih Sharon2,Kobashigawa Jon3ORCID,Madsen Joren C4,Tellides George5ORCID

Affiliation:

1. Department of Immunobiology, Pathology and Dermatology, Yale School of Medicine, 10 Amistad Street, New Haven CT 06520-8089, USA

2. Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada

3. Department of Medicine, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA

4. Division of Cardiac Surgery and Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

5. Department of Surgery (Cardiac Surgery), Yale School of Medicine, New Haven, CT, USA

Abstract

Abstract Cardiac allograft vasculopathy (CAV) is a pathologic immune-mediated remodelling of the vasculature in transplanted hearts and, by impairing perfusion, is the major cause of late graft loss. Although best understood following cardiac transplantation, similar forms of allograft vasculopathy occur in other vascularized organ grafts and some features of CAV may be shared with other immune-mediated vasculopathies. Here, we describe the incidence and diagnosis, the nature of the vascular remodelling, immune and non-immune contributions to pathogenesis, current therapies, and future areas of research in CAV.

Funder

National Institutes of Health

Heart and Stroke Foundation Canada Ontario Clinician Scientist Phase I award and a Tier 2 University of Ottawa Clinical Research Chair in Cardiac Transplantation

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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