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Orthotopic heart transplantation (OHTx) represents a well established method of end-stage heart failure treatment. Allograft coronary artery disease (CAD) still remains to be one of the most important limiting factors for OHTx recipients’ long-term survival. Unfortunately, allograft CAD can be detected very early after OHTx. Our study was designed to identify risk factors for early allograft CAD development. Eighty-three OHTx recipients (18 females, 65 males, mean age 50.55 ± 11.04 years) with coronary intravascular ultrasound examination performed early after OHTx (29.81 ± 12.45 days) formed the study population. The impact of a number of pre-, peri- and early post-transplant possible risk factors on early allograft CAD development was studied. By multivariate analysis, only higher donor age ( P < 0.001) and higher recipient's body mass index ( P = 0.003) were found to represent risk factors for the early development of allograft CAD. [ABSTRACT FROM AUTHOR]

The usefulness of phosphorus-31 nuclear magnetic resonance spectroscopy (31P NMRS) from detecting heart graft rejection after transplantation has been investigated by several researchers, and it has thus been demonstrated to be a valid technique for detecting acute myocardial rejection. In this study, we investigated the value of31P NMRS to assess chronic cardiac allograft rejection. Lewis rat hearts were transplanted into the femoral region of F-344 rat recipients which were treated with cyclosporine, 5 mg/kg body weight, by a daily intramuscular injection for 30 days beginning on the day of transplantation. The control isografts employed Lewis donors and recipients not given cyclosporine. The ratios of phosphocreatine (PCr) to inorganic phosphate (Pi), β-adenosine trisphosphate (β-ATP) to Pi, and PCr to β-ATP were monitored using surface coil31P NMRS.31P NMRS was performed 3, 30, and 60 days after transplantation, and the degree of the rejection and arteriosclerosis of the coronary arteries were then assessed histologically. The PCr:Pi and β-ATP:Pi ratios for the allografts demonstrated a significant decrease on postoperative day (POD) 60 from that on POD 30 (PCr:Pi, P<0.001; β-ATP:Pi, P<0.01). Although a significant difference existed between the isografts and allografts on POD 60 (PCr:Pi, P<0.01; β-ATP:Pi, P<0.01), no significant difference was found in the PCr:β-ATP ratio between the allografts and the isografts. On POD 60, the allografts showed significant graft rejection and arterio-sclerotic changes in the coronary arteries. These findings therefore demonstrated the effectiveness of31P NMRS for detecting chronic graft rejection in a rat model. [ABSTRACT FROM AUTHOR]