Cardiac-Allograft Vasculopathy

Vasculopathy of cardiac allografts is a major therapeutic challenge, occurring in 50 percent or more of heart-transplant recipients in the first several years after surgery. Improving survival for these patients will require the use of new strategies to prevent this relentlessly progressive complication. Allograft vasculopathy involves diffuse narrowing and occlusion of the coronary arteries, rather than the more focal lesions of conventional atherosclerosis (see Figure).1 The addition of intravascular ultrasonography to standard coronary angiography increases the sensitivity of the procedure for diagnosis and provides a concentric view of the vessel under study.Events during the first year after transplantation appear . . .