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.
Keywords:
chronic rejection; endothelial cells; heart transplantation; innate and adaptive immunity; vascular smooth muscle cells.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adaptive Immunity
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Animals
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Coronary Artery Disease / epidemiology
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Coronary Artery Disease / immunology*
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Coronary Artery Disease / metabolism
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Coronary Artery Disease / pathology
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Coronary Vessels / immunology*
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Coronary Vessels / metabolism
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Coronary Vessels / pathology
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Endothelial Cells / immunology
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Endothelial Cells / metabolism
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Endothelial Cells / pathology
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Graft Rejection / epidemiology
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Graft Rejection / immunology*
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Graft Rejection / metabolism
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Graft Rejection / pathology
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Graft Survival
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Heart Transplantation / adverse effects*
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Humans
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Immunity, Innate
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Muscle, Smooth, Vascular / immunology
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Muscle, Smooth, Vascular / metabolism
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Muscle, Smooth, Vascular / pathology
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Myocytes, Smooth Muscle / immunology
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Myocytes, Smooth Muscle / metabolism
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Myocytes, Smooth Muscle / pathology
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Risk Factors
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Signal Transduction
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Treatment Outcome
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Vascular Remodeling