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Super Accelerated Cardiac Allograft Vasculopathy

Abstract:

Introduction Cardiac allograft vasculopathy (CAV) is common in heart transplant patients, and remains the leading long-term cause of death and re-transplantation. CAV is primarily an immunologically mediated disease thus, immune risks associated the host's allogeneic response likely outweigh non-immune risk factors. Case Report A 50-year-old, obese woman who underwent heart transplant 2 years ago due to non-obstructive HCM, was admitted with congestive heart failure that progressed in 3 weeks. She had previous preserved graft function, no history of rejection and was under immunosuppressive therapy with steroid, AZA and CSA. The TTE revealed severe RV dysfunction and mild LV dysfunction, slightly elevated hs-cTnT, and nonspecific abnormalities on ECG. Angiogram showed no coronary lesion. Empirical treatment with steroid pulse and IVIG was chosen. As she presented 1R, C4d- on EMB …