Transplant-Associated Coronary Artery Vasculopathy / Edition 1

by Rohit N. Kulkarni

Overview

Cardiac transplantation has had a major impact on the quality of life and longevity of an ever-increasing number of patients. This benefit is significantly eroded by the development of an accelerated form of coronary arterial disease which shows some, but not all, of the characteristics of native coronary artery disease, and itself is one of the major indications for transplantation.

If cardiac transplantation is to realize its potential, it is essential to prevent transplant-related coronary disease. This can only be done by thorough understanding of the basic mechanisms involved. This could help in the fight against native atherosclerosis, which has a major impact on the community and in preventing vascular damage after other solid organ transplantation. To date, there is no agreement or good guidelines about the management of chronic rejection. Transplant-associated coronary disease is a multifactorial disease contributed by genetic factors in the donor and recipients. It is also linked to events occurring during brain death, harvesting and implantation, and most importantly, events after transplantation. The latter events can be conveniently divided into antigen-dependent and antigen-independent with immunological causes playing a part in both.

Recent work has resulted in major and significant accumulation of knowledge in this field, particularly in the molecular mechanisms and to some extent, management, of the disease. This knowledge is extensively and methodically reviewed in this volume by a group of experts in the field.

Product Details

ISBN-13:	9781587060052
Publisher:	Taylor & Francis
Publication date:	09/16/2014
Series:	Medical Intelligence Unit Ser.
Pages:	204
Product dimensions:	6.20(w) x 9.20(h) x 0.80(d)

Table of Contents

Coronary Arterial Disease in the Cardiac Allograft. Atherosclerosis: Response to Injury. The Immune Response to Endothelial Cells. Role of Hemostasis, Anticoagulation, Fibrinolysis and Endothelial Activation. Nonimmune Factors in the Etiology of Graft Coronary Arteriosclerosis. Tissue Remodeling and Extracellular Matrix Proteins Insights Regarding the Pathogenesis of Transplant Arteriopathy from Experiments with Animals. Cytomegalovirus as a Contributing Factor in Transplant Vascular Sclerosis. Lipids and Lipid Lowering Therapy. Immunosuppressive Drugs for the Prevention and Treatment of Transplant Coronary Artery Vasculopathy.

Editorial Reviews

Reviewer: Nader Moazami, MD (Washington University School of Medicine)
Description: Significant advances in all aspects of cardiac transplantation in the last two decades have had a dramatic impact on the survival of many patients suffering from endstage heart failure. Transplant coronary artery disease remains the Achilles heel of cardiac transplantation in terms of the ability to extend the survival of this young group of patients beyond what is currently possible. This book offers an excellent review of our current understanding of this process based on extensive experimental and clinical work. Each chapter deals with various transplant and non-transplant related factors that play a role in the complicated process of initiation and progression of graft atherosclerosis. This book is an excellent addition to the current literature for all investigators interested in heart transplantation and cardiac allograft vasculopathy.
Purpose: The purpose is to review the current understanding of cardiac allograft vasculopathy and differentiate it from native coronary artery disease. It is important for all those involved in the field of cardiac transplantation to appreciate the multiple transplant and patient-related factors that contribute to this prosess. These objectives are clearly met.
Audience: The book has a wide range of readership and is written in a way that can benefit all those interested in understanding coronary graft arteriopathy. Medical students, transplant surgeons, heart failure practitioners, and nurses can all benefit from this well-written book. The particular audience, however, is primarily laboratory investigators and heart transplant specialists involved in the care of patients. The authors are all experts in the field.
Features: The book provides extensive coverage of the topic and the chapters are arranged in an orderly fashion addressing the factors that contribute to transplant-related coronary artery disease. The first chapter gives an overview, defining the disease process, detailing the epidemiology of the process and discussing current methods for detection. Each subsequent chapter then dwells on the risk factors and pathophysiology of graft atherosclerosis in more detail. These include a thorough review of the atherosclerosis process, inflammatory mediators, immune and nonimmune factors, and the endothelial response.
Assessment: I find the book an important contribution to the field of cardiac transplantation. It provides insight into understanding graft vasculopathy and can be used as an excellent reference source.

Doody's Review Service

4 Stars! from Doody

Heart transplants often result in the development of an accelerated form of coronary arterial disease, recent studies of which are presented here in ten chapters by specialists in the US, UK, and Canada. Topics include: atherosclerosis as a response to injury; the immune response to endothelial cells; the role of hemostasis, anticoagulation, fibrinolysis and endothelial activation; nonimmune factors in the etiology of graft coronary arteriosclerosis; tissue remodeling and extracellular matrix proteins; findings from animal experiments on the pathogenesis of transplant arteriopathy; cytomegalovirus as a contributing factor; lipids and lipid lowering therapy; and immunosuppressive drugs. Rose is affiliated with the Imperial College School of Medicine in Harefield, Middlesex, UK. Annotation c. Book News, Inc., Portland, OR (booknews.com)

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