TITLE:
Pathogenesis of cardiac graft failure in children
AUTHORS:
Jenny Lin, Bahig M. Shehata
KEYWORDS:
Cardiac Graft Failure; Pediatric Cardiac Transplant
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.2 No.4,
December
13,
2012
ABSTRACT: For many critical cardiac conditions such as cardio-myopathy, congenital heart defects, or arrhythmogenic disorders, cardiac transplantation is often an accepted treatment with optimistic one- and five-year survival rates of 90% and 75% in the pediatric patient population, respectively. However, poor long-term survival is a cause for concern, with cardiac graft failure being the leading cause in late mortality transplant recipients. Cardiac graft failure occurs through several mechanisms. However, the most common causes include cardiac allograft vasculopathy, myocardial fibrosis, and fibrofatty changes. Risk factors exacerbate these mechanisms through rejection, immunosuppressive drug side effects, hypertension, diabetes mellitus, renal dysfunction, and viral infection to increase the chance of cardiac graft failure. Changes in expression levels of various genes offer diagnostic potential for the future of cardiac transplantation. Through a comprehensive review of how multiple factors can lead a cardiac graft into failure, we hope to contribute to the longevity of cardiac grafts and pediatric heart transplant recipients.