Cardiac Transplantation

Cardiac Allograft Vasculopathy: An Ongoing Challenge in the Care of Heart Transplant Recipients (Chronic Rejection in Cardiac Transplantation) Part 2

Donor-recipient factors Donor-recipient factors that increase risk of CAV include episodes of high-grade cellular rejection during the first year after transplantation, HLA-DR mismatches, antibody mediated rejection (including asymptomatic AMR), and cytomegalovirus (CMV) infection. The total cellular rejection score at six months increases the risk of CAV by almost threefold (Raichlin et al., 2009). The total […]

Role of Matricellular Proteins in Cardiac Allograft Fibrosis (Chronic Rejection in Cardiac Transplantation) Part 1

Introduction While acute rejection of solid organ allografts has become a rare clinical condition, long-term graft survival is threatened by the development of fibrosis. Such fibrosis is seen in two forms in the heart, one being an accelerated process of atherosclerosis termed transplant vasculopathy, the second a parenchymal response to the ensuing ischemia, low-grade cellular […]

Role of Matricellular Proteins in Cardiac Allograft Fibrosis (Chronic Rejection in Cardiac Transplantation) Part 2

Matricellular proteins in action Matricellular proteins in solid organ transplantation Data on matricellular protein expression and function in the cardiac allografts is limited (Franz et al., 2010; Mikalsen et al., 2010; Zhao et al., 2001) but justifies further investigation. For example, TV has been associated with elevated levels of thrombospondin-1 (Zhao et al., 2001) and […]

Potential of Heterotopic Cardiac Transplantation in Mice as a Model for Elucidating Mechanisms of Graft Rejection (Experimentation in Cardiac Transplantation) Part 1

Introduction Cardiac transplantation displays a well established therapeutic procedure for different end-stage heart diseases. Effective immunosuppressive drugs, progress in operative techniques, modern perioperative intensive care, and application of increasingly potent antibiotics in case of postoperative infections led to an improvement in short term outcome of organ transplantation. Nevertheless, achievements in long term transplant results are […]

Potential of Heterotopic Cardiac Transplantation in Mice as a Model for Elucidating Mechanisms of Graft Rejection (Experimentation in Cardiac Transplantation) Part 2

Recipient preparation and transplantation For the recipient operation narcosis, fixation on the corkboard, and median laparotomy from the symphysis to the lower margin of the left hepatic lobe are performed as described above during the donor operation. After opening the abdominal cavity and fixation of the peritoneum with two needles (alternatively a self-retaining retractor can […]

Pre-Transplant Therapy in Experimental Heart Transplantation (Experimentation in Cardiac Transplantation)

Introduction Heart transplantation is a life-saving procedure for patients with end-stage cardiac dysfunction. Currently one-year graft survival ranges between 77-88%, three-year survival between 77-79% and five-year survival between 67-73% (http://www.americanheart.org/presenter.jhtml?identifier=4588). Despite these encouraging results, primary graft failure accounts for about 23% of deaths in the first 90 days post transplantation. Pretransplant variables associated with primary […]

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