Cardiac allograft vasculopathy epidemiology and demographics

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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

As per the data from the Registry of the International Society of Heart and Lung transplantation[1], the number of reported heart transplants has increased slowly in the recent years, especially in North America. The overall prevalence of CAV in post-cardiac transplant patients at 1, 5 and 10 years is 8, 30 and 50% respectively.

Epidemiology and Demographics

As per the ISHLT, the prevalence of CAV in post- cardiac transplant patients at 1, 5 and 10 years is 8, 30 and 50% respectively. The incidence of CAV has decreased slightly over time. Moreover, CAV as a cause of death in patients post- transplantation has decreased over the last decade. Donor age, donor history of hypertension, hyperlipidemia, number of HLA mismatches and recipient diagnosis of ischemic heart disease were important predictors for development of CAV. Similar results were derived from the review of the United Network of Organ Sharing (UNOS) heart transplant database was performed by Nagji and colleagues in 2010 [2].

The Cardiac Transplant Research Database revealed a higher incidence of CAV in post-transplant patients of 42% at the end of 5 years, whereas only 7% of patients were found to have severe CAV on coronary angiogram over the same period of time. The presence of severe CAV was highly predictive of subsequent events or re-transplantation. Similar to the ISHLT and UNOS, older donor age, male donor or recipient, donor hypertension, diabetes were predictive of development of CAV.

References

  1. Taylor DO, Edwards LB, Boucek MM, Trulock EP, Aurora P, Christie J; et al. (2007). "Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult heart transplant report--2007". J Heart Lung Transplant. 26 (8): 769–81. doi:10.1016/j.healun.2007.06.004. PMID 17692781.
  2. Nagji AS, Hranjec T, Swenson BR, Kern JA, Bergin JD, Jones DR; et al. (2010). "Donor age is associated with chronic allograft vasculopathy after adult heart transplantation: implications for donor allocation". Ann Thorac Surg. 90 (1): 168–75. doi:10.1016/j.athoracsur.2010.03.043. PMC 3033784. PMID 20609769.

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