Donor-Transmitted Atherosclerosis Associated With Worsening Cardiac Allograft Vasculopathy After Heart Transplantation: Serial Volumetric Intravascular Ultrasound Analysis. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Watanabe, Takuya; Seguchi, Osamu; Yanase, Masanobu; Fujita, Tomoyuki; Murata, Yoshihiro; Sato, Takuma; Sunami, Haruki; Nakajima, Seiko; Kataoka, Yu; Nishimura, Kunihiro; Hisamatsu, Eriko; Kuroda, Kensuke; Okada, Norihiro; Hori, Yumiko; Wada, Kyoichi; Hata, Hiroki; Ishibashi-Ueda, Hatsue; Miyamoto, Yoshihiro; Fukushima, Norihide; Kobayashi, Junjiro; Nakatani, Takeshi
• Is Part Of: Transplantation. Volume 101:Issue 6(2017)
• Publication Date: 2017-06
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/TP.0000000000001322
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Background: The influence of preexisting donor-transmitted atherosclerosis (DA) on cardiac allograft vasculopathy (CAV) development remains unclear. Methods: We performed 3-dimensional intravascular ultrasound (3D-IVUS) analysis in 42 heart transplantation (HTx) recipients at 2.1 ± 0.9 months (baseline) and 12.2 ± 0.4 months post-HTx, as well as consecutive 3D-IVUS analyses up to 3 years post-HTx in 35 of the 42 recipients. Donor-transmitted atherosclerosis was defined as a maximal intimal thickness of 0.5 mm or greater at baseline. Changes in volumetric IVUS parameters were compared in recipients with (DA group) and without DA (DA-free group) at baseline, 1 year, and 3 years post-HTx. Results: Donor-transmitted atherosclerosis was observed in 57.1% of 42 recipients. The DA group exhibited a significantly greater increase in plaque volume at 1 year post-HTx ( P < 0.001), leading to increased percent plaque volume (plaque volume/vessel volume, [%]) ( P < 0.001) and decreased luminal volume ( P = 0.021). Donor-transmitted atherosclerosis was independently associated with a greater increase in percent plaque volume during the first post-HTx year ( P = 0.011). From 1 to 3 years post-HTx, the DA group underwent continuous reduction in luminal volume ( P = 0.022). These changes resulted in a higher incidence of angiographic CAV at 3 years post-HTx in the DA group (58.8% vs 5.6%, P = 0.002). Conclusions: This volumetric IVUS study suggests that DA correlates with the worsening change in CAV several years post-HTx. Donor-transmitted atherosclerosis recipients may require more aggressive treatment to prevent subsequent CAV progression. Abstract : Donor-transmitted atherosclerosis in cardiac transplants, the impact of which is controversial, associates with greater reduction in coronary artery lumen and cardiac allograft vasculopathy at 3 years after transplantation. Supplemental digital content is available in the text.