ALLOGRAFT AORTOPATHY - AN IN-VIVO STUDY OF DONOR AORTA INVOLVEMENT INCARDIAC ALLOGRAFT VASCULOPATHY

Limited histopathologic studies of failed cardiac allografts have demo nstrated that cardiac allograft vasculopathy extends into the donor ao rta; however, no study has examined the development of allograft aorti c intimal proliferation in vivo in conjunction with coronary intimal h yperplasia. By using simultaneous intracoronary and intraaortic ultras ound, we studied 20 consecutive heart transplant recipients at 2.5 +/- 2.1 years after transplantation. The degree of coronary intimal thick ening was strongly correlated with the development of intraaortic inti mal hyperplasia (r = 0.90; p < 0.0001). Multivariate predictors of aor tic intimal thickening included years after transplant (r = 0.47; p = 0.03), serum cholesterol level (r = 0.65, p = 0.003), and serum trigly ceride level (r = 0.51; p = 0.03). Allograft aortopathy occurs in a si milar manner to allograft coronary disease, thus providing support for the notion that an immunologic stimulus operating across the allograf t vascular bed may be responsible for the development of cardiac allog raft vasculopathy. Furthermore, this investigation provides insight in to the putative role of hyperlipidemia in allograft vascular disease.