Diagnosis and Management of Graft Atherosclerosis (Chronic Rejection)

Cardiac transplantation has become an accepted therapeutic modality for end-stage heart failure. It is expected that each year approximately 2000 cardiac transplant procedures will be performed worldwide with a 1-year survival exceeding 80%1. These statistics reflect dramatic advances in cardiac transplantation over the past decade. Although rejection and infection are still primary concerns, they are no longer the nemesis of the allograft recipient who survives the immediate postoperative period. Instead, accelerated coronary artery disease (CAD) has become the leading cause of death among those transplant recipients who survive a year or longer after surgery.