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Transplant Associated Coronary Artery Disease

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The Role of Immune Mechanisms in Cardiovascular Disease

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Abstract

Heart transplantation is the clinically acceptable treatment for end-stage heart failure. Since the development of better immunosuppressive regimes and particularly the introduction of Cyclosporin A in 1983, which combats cellular rejection, short-term survival for heart transplant recipients has increased steadily with survival at 1 year being in the order of 85% (Kriett and Kaye 1990). The major medium to long-term complication is development of a proliferative occlusive disease of the vasculature of the allograft. This disease, variously described as transplant associated coronary artery disease (TxCAD; Rose and Dunn 1993), cardiac allograft vasculopathy (CAV; Hosenpud et al. 1992), accelerated coronary artery sclerosis (ACS; Yacoub and Rose, 1994) and graft coronary artery sclerosis (GCA; Schoen and Libby 1991), is a rapidly progressing disease which causes blockage of the coronary arteries. The incidence of TxCAD varies between heart transplant centres. Harefield Hospital, U.K. has an incidence of 6% at 1 year increasing to 17% at 3 years (see Dunn and Rose, 1993), however, other centres have reported incidences as high as 10%–20% at 1 year, 25%–40% at 3 years and at least 40%–50% at 5 years (Gao et al. 1989; Uretsky et al. 1987).

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Authors and Affiliations

  1. National Heart and Lung Institute, Heart Science Centre, Harefield Hospital, Harefield, Middlesex, UB9 6JH, UK

    C. H. Wheeler, A. D. Collins, M. J. Dunn, S. J. Crisp, M. H. Yacoub & M. L. Rose

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  1. C. H. Wheeler
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  2. A. D. Collins
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  3. M. J. Dunn
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  4. S. J. Crisp
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  5. M. H. Yacoub
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  1. Abteilung für Kardiologie/Pulmologie, Universitätsklinikum Benjamin Franklin der Freien Universität Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Heinz-Peter Schultheiss  & Peter Schwimmbeck  & 

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Wheeler, C.H., Collins, A.D., Dunn, M.J., Crisp, S.J., Yacoub, M.H., Rose, M.L. (1997). Transplant Associated Coronary Artery Disease. In: Schultheiss, HP., Schwimmbeck, P. (eds) The Role of Immune Mechanisms in Cardiovascular Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60463-8_14

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  • DOI: https://doi.org/10.1007/978-3-642-60463-8_14

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