Ventura H O, Mehra M R, Smart F W, Stapleton D D
Ochsner Medical Institutions, New Orleans, LA 70121.
Am Heart J. 1995 Apr;129(4):791-9. doi: 10.1016/0002-8703(95)90331-3.
The major cause of late death in cardiac transplant recipients is cardiac allograft vasculopathy, also referred to as cardiac transplant atherosclerosis, which occurs in 15% to 20% of transplant recipients. It differs from traditional atherosclerosis in that it is a concentric and diffuse intimal hyperplastic process; the internal elastic lamina remains intact; calcification is rare; and the disease tends to develop rapidly. Although no definitive reason for cardiac allograft vasculopathy has been established, it has been suggested that it may be caused by a combination of immunologic and nonimmunologic damage to endothelial cells that results in myointimal proliferation. Intravascular ultrasound and coronary angioscopy are more sensitive diagnostic measures of cardiac allograft vasculopathy than coronary angiography. Although retransplantation currently seems to be the only definitive therapy for cardiac allograft vasculopathy, it has shown only fair results.
心脏移植受者晚期死亡的主要原因是心脏移植血管病变，也称为心脏移植动脉粥样硬化，发生于15%至20%的移植受者中。它与传统动脉粥样硬化不同，是一种同心性和弥漫性内膜增生过程；内弹力层保持完整；钙化罕见；且该疾病往往发展迅速。尽管尚未确定心脏移植血管病变的确切原因，但有人提出，它可能是由对内皮细胞的免疫和非免疫损伤共同导致肌内膜增殖引起的。血管内超声和冠状动脉血管镜检查对心脏移植血管病变的诊断比冠状动脉造影更敏感。尽管目前再次移植似乎是心脏移植血管病变的唯一确定性治疗方法，但其效果仅为中等。
