CAV Trajectories Among Patients With No or Mild CAV at 10 Years Posttransplant

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-10-22 DOI:10.1111/ctr.70009

Erin Harris, Nikil Prasad, Devin Skoll, Sambhavi Sneha Kumar, Justin Fried, Veli Topkara, Jayant K. Raikhelkar, Ersilia M. DeFilippis, Farhana Latif, Melana Yuzefpolskaya, Paolo C. Colombo, Nir Uriel, Koji Takeda, Gabriel T. Sayer, Kevin J. Clerkin

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Abstract

Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality following heart transplantation (HT). Prior studies identified distinct CAV trajectories in the early post-HT period with unique predictors, but the evolution of CAV in later periods is not well-described. This study assessed the prevalence of late CAV progression and associated risk factors in HT recipients with ISHLT CAV 0/1 at 10 years post-HT. Consecutive adult patients who underwent HT from January 2000 to December 2008 were evaluated and grouped by CAV trajectories into progressors (developed ISHLT CAV 2/3) or nonprogressors (remained ISHLT CAV 0/1). A total of 130 patients were included with a median age at angiography of 61.7 years and a median follow-up time of 4.8 years. 8.5% progressed to CAV 2/3, while the remaining 91.5% were nonprogressors. Progression was not associated with death or retransplantation (27.3% [progressor] vs. 21.0% [nonprogressor], p = 0.70). These data may inform shared decision-making about late CAV screening.

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移植后 10 年无 CAV 或轻度 CAV 患者的 CAV 轨迹。

心脏移植物血管病（CAV）是心脏移植（HT）后发病和死亡的主要原因。先前的研究确定了心脏移植术后早期不同的 CAV 发展轨迹和独特的预测因素，但对后期 CAV 的演变还没有很好的描述。本研究评估了 HT 受者中 ISHLT CAV 0/1 在 HT 术后 10 年的晚期 CAV 进展的发生率和相关风险因素。研究人员对 2000 年 1 月至 2008 年 12 月期间接受 HT 的连续成年患者进行了评估，并根据 CAV 的发展轨迹将其分为进展者（发展为 ISHLT CAV 2/3）和非进展者（保持 ISHLT CAV 0/1）。共纳入 130 名患者，血管造影时的中位年龄为 61.7 岁，中位随访时间为 4.8 年。8.5%的患者进展为CAV 2/3，其余91.5%的患者未进展。进展与死亡或再移植无关（27.3% [进展者] vs. 21.0% [未进展者]，p = 0.70）。这些数据可为CAV晚期筛查的共同决策提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.