Low incidence of transplant coronary artery disease in Chinese heart recipients

OBJECTIVES This study sought to assess the incidence of transplant coronary artery Chi nese heart recipients. BACKGROUND The prevalence of transplant CAD detected by angiography ar 1, 2 and 4 year s after heart transplantation was 11%, 22% and 45%, respectively. The incid ence of transplant CAD in Chinese heart recipients has not been reported. METHODS For those recipients surviving for more than 1 year after transplantation, coronary angiography was performed annually for surveillance of transplant CAD. The recipient characteristics, donor characteristics, rejection episod es, medication and human leukocyte antigen (HLA mismatches were recorded. RESULTS Fifty patients were included in this study. Thirteen (26%) recipients had i schemic heart disease. Two patients (4%) had active cytomegalovirus (CMV) i nfection after transplantation The mean number of rejection episodes in the 1st year after transplantation was 1.15. Among 47 patients with complete d ata of donor and recipient histocompatibility antigens, there were seven pa tients (14.9%) with two or fewer HLA mismatches Among 74 angiograms of 50 p atients reviewed, only one patient had discrete stenosis less than 50% in t he middle portion of the left anterior descending artery at 1 year after tr ansplantation The cumulative incidence of transplant CAD was 2% at 1 year a nd 2% at 2 and 4 years after transplantation. CONCLUSIONS The incidence of transplant CAD was low in Chinese heart transplant recipie nts Low percentage of ischemic heart disease in recipients, low occurrence of active CMV infection and rejection episodes after transplantation, less racial disparity, and lower HLA mismatches maybe the important factors. (C) 1999 by the American college of Cardiology.