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Mild acute cellular rejection and development of cardiac allograft vasculopathy assessed by intravascular ultrasound and coronary angiography in heart transplant recipients—a SCHEDULE trial substudy

Nelson, Lærke Marie ; Andreassen, Arne Kristian ; Arora, Satish ; Andersson, Bert ; Gude, Einar ; Eiskjær, Hans ; Rådegran, Göran LU ; Dellgren, Göran ; Gullestad, Lars and Gustafsson, Finn (2020) In Transplant International
Abstract

To evaluate the association between mild acute cellular rejection (ACR) and the development of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). Substudy of the SCHEDULE trial (n = 115), where de novo HTx recipients were randomized to (i) everolimus with early CNI elimination or (ii) CNI-based immunosuppression. Seventy-six patients (66%) were included based on matched intravascular ultrasound (IVUS) examinations at baseline and year 3 post-HTx. Biopsy-proven ACR within year 1 post-HTx was recorded and graded (1R, 2R, 3R). Development of CAV was assessed by IVUS and coronary angiography at year 3 post-HTx. Median age was 53 years (45–61), and 71% were male. ACR was recorded in 67%, and patients were grouped by... (More)

To evaluate the association between mild acute cellular rejection (ACR) and the development of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). Substudy of the SCHEDULE trial (n = 115), where de novo HTx recipients were randomized to (i) everolimus with early CNI elimination or (ii) CNI-based immunosuppression. Seventy-six patients (66%) were included based on matched intravascular ultrasound (IVUS) examinations at baseline and year 3 post-HTx. Biopsy-proven ACR within year 1 post-HTx was recorded and graded (1R, 2R, 3R). Development of CAV was assessed by IVUS and coronary angiography at year 3 post-HTx. Median age was 53 years (45–61), and 71% were male. ACR was recorded in 67%, and patients were grouped by rejection profile: no ACR (33%), only 1R (42%), and ≥2R (25%). Median ∆MIT (maximal intimal thickness)BL-3Y was not significantly different between groups (P = 0.84). The incidence of CAV was 49% by IVUS and 26% by coronary angiography with no significant differences between groups. No correlation was found between number of 1R and ∆MITBL-3Y (r = −0.025, P = 0.83). The number of 1R was not a significant predictor of ∆MITBL-3Y (P = 0.58), and no significant interaction with treatment was found (P = 0.98). The burden of mild ACR was not associated with CAV development.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
acute cellular rejection, cardiac allograft vasculopathy, coronary angiography, heart transplantation, intravascular ultrasound, mild rejection
in
Transplant International
publisher
Springer
external identifiers
  • pmid:31958178
  • scopus:85079217667
ISSN
0934-0874
DOI
10.1111/tri.13577
language
English
LU publication?
yes
id
e6f99105-218b-4c5d-9f67-9f57d56ef6d3
date added to LUP
2020-02-21 14:01:46
date last changed
2020-07-08 05:13:15
@article{e6f99105-218b-4c5d-9f67-9f57d56ef6d3,
  abstract     = {<p>To evaluate the association between mild acute cellular rejection (ACR) and the development of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). Substudy of the SCHEDULE trial (n = 115), where de novo HTx recipients were randomized to (i) everolimus with early CNI elimination or (ii) CNI-based immunosuppression. Seventy-six patients (66%) were included based on matched intravascular ultrasound (IVUS) examinations at baseline and year 3 post-HTx. Biopsy-proven ACR within year 1 post-HTx was recorded and graded (1R, 2R, 3R). Development of CAV was assessed by IVUS and coronary angiography at year 3 post-HTx. Median age was 53 years (45–61), and 71% were male. ACR was recorded in 67%, and patients were grouped by rejection profile: no ACR (33%), only 1R (42%), and ≥2R (25%). Median ∆MIT (maximal intimal thickness)<sub>BL-3Y</sub> was not significantly different between groups (P = 0.84). The incidence of CAV was 49% by IVUS and 26% by coronary angiography with no significant differences between groups. No correlation was found between number of 1R and ∆MIT<sub>BL-3Y</sub> (r = −0.025, P = 0.83). The number of 1R was not a significant predictor of ∆MIT<sub>BL-3Y</sub> (P = 0.58), and no significant interaction with treatment was found (P = 0.98). The burden of mild ACR was not associated with CAV development.</p>},
  author       = {Nelson, Lærke Marie and Andreassen, Arne Kristian and Arora, Satish and Andersson, Bert and Gude, Einar and Eiskjær, Hans and Rådegran, Göran and Dellgren, Göran and Gullestad, Lars and Gustafsson, Finn},
  issn         = {0934-0874},
  language     = {eng},
  month        = {01},
  publisher    = {Springer},
  series       = {Transplant International},
  title        = {Mild acute cellular rejection and development of cardiac allograft vasculopathy assessed by intravascular ultrasound and coronary angiography in heart transplant recipients—a SCHEDULE trial substudy},
  url          = {http://dx.doi.org/10.1111/tri.13577},
  doi          = {10.1111/tri.13577},
  year         = {2020},
}