Cardiac allograft vasculopathy medical therapy: Difference between revisions
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===Nonpharmacologic Interventions=== | ===Nonpharmacologic Interventions=== | ||
* Retransplantation | * Retransplantation | ||
* [[Percutaneous coronary | * [[Percutaneous coronary intervention]]s | ||
* Coronary artery bypass grafting | * [[Coronary artery bypass grafting]] | ||
* Transmyocardial | * [[Transmyocardial revascularization]] | ||
* Heparin induced/mediated extracorporeal LDL plasmapheresis (HELP) | * Heparin induced/mediated extracorporeal LDL plasmapheresis (HELP) | ||
====Retransplantation==== | |||
* Retransplantation is the only definitive treatment for CAV. It is associated with satisfactory survival in patients with CAV. | |||
* About 60% of the repeat transplantation procedures performed are due to graft failure secondary to CAV <ref name="pmid16686747">{{cite journal| author=Mehra MR| title=Contemporary concepts in prevention and treatment of cardiac allograft vasculopathy. | journal=Am J Transplant | year= 2006 | volume= 6 | issue= 6 | pages= 1248-56 | pmid=16686747 | doi=10.1111/j.1600-6143.2006.01314.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16686747 }} </ref>. It is a higher risk procedure and raises significant ethical concerns primarily because of scarcity of heart transplant donors <ref name="pmid12909465">{{cite journal| author=Radovancevic B, McGiffin DC, Kobashigawa JA, Cintron GB, Mullen GM, Pitts DE et al.| title=Retransplantation in 7,290 primary transplant patients: a 10-year multi-institutional study. | journal=J Heart Lung Transplant | year= 2003 | volume= 22 | issue= 8 | pages= 862-8 | pmid=12909465 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12909465 }} </ref>. | |||
* Prognosis: One year survival has improved in recent years, but continues to be inferior compared to primary transplants (79% in re-transplant group compared to 85% in primary transplant group) <ref name="pmid10972218">{{cite journal| author=Srivastava R, Keck BM, Bennett LE, Hosenpud JD| title=The results of cardiac retransplantation: an analysis of the Joint International Society for Heart and Lung Transplantation/United Network for Organ Sharing Thoracic Registry. | journal=Transplantation | year= 2000 | volume= 70 | issue= 4 | pages= 606-12 | pmid=10972218 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10972218 }} </ref>. | |||
==References== | ==References== | ||
Revision as of 05:02, 9 December 2014
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Cardiac allograft vasculopathy Microchapters |
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Differentiating Cardiac allograft vasculopathy from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Cardiac allograft vasculopathy medical therapy On the Web |
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American Roentgen Ray Society Images of Cardiac allograft vasculopathy medical therapy |
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Directions to Hospitals Treating Cardiac allograft vasculopathy |
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Risk calculators and risk factors for Cardiac allograft vasculopathy medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Raviteja Guddeti, M.B.B.S. [3]
Overview
Medical Therapy
Pharmacologic Management
Nonpharmacologic Interventions
- Retransplantation
- Percutaneous coronary interventions
- Coronary artery bypass grafting
- Transmyocardial revascularization
- Heparin induced/mediated extracorporeal LDL plasmapheresis (HELP)
Retransplantation
- Retransplantation is the only definitive treatment for CAV. It is associated with satisfactory survival in patients with CAV.
- About 60% of the repeat transplantation procedures performed are due to graft failure secondary to CAV [1]. It is a higher risk procedure and raises significant ethical concerns primarily because of scarcity of heart transplant donors [2].
- Prognosis: One year survival has improved in recent years, but continues to be inferior compared to primary transplants (79% in re-transplant group compared to 85% in primary transplant group) [3].
References
- ↑ Mehra MR (2006). "Contemporary concepts in prevention and treatment of cardiac allograft vasculopathy". Am J Transplant. 6 (6): 1248–56. doi:10.1111/j.1600-6143.2006.01314.x. PMID 16686747.
- ↑ Radovancevic B, McGiffin DC, Kobashigawa JA, Cintron GB, Mullen GM, Pitts DE; et al. (2003). "Retransplantation in 7,290 primary transplant patients: a 10-year multi-institutional study". J Heart Lung Transplant. 22 (8): 862–8. PMID 12909465.
- ↑ Srivastava R, Keck BM, Bennett LE, Hosenpud JD (2000). "The results of cardiac retransplantation: an analysis of the Joint International Society for Heart and Lung Transplantation/United Network for Organ Sharing Thoracic Registry". Transplantation. 70 (4): 606–12. PMID 10972218.