Relationship of fibrin deposition in microvasculature to outcomes in cardiac transplantation

The development of transplant coronary artery disease (CAD) is directly ass ociated with outcome in cardiac transplantation. The relationship between m icrovascular fibrin deposition early after transplantation and subsequent d evelopment of transplant GAD is discussed in this article. In this article the presence of microvascular fibrin and its association wi th other prothrombogenic changes within the cardiac microvasculature, such as loss of vascular antithrombin, depletion of arteriolar tissue plasminoge n activator, and presence of arterial and arteriolar endothelium activation , as well as changes in circulation associated with prothrombogenic changes that have predictive value for subsequent transplant outcome are presented and discussed. Novel therapeutic approaches that may prevent the developme nt of transplant CAD and consequently affect outcome are considered.