Activation of the endothelium in cardiac allografts

Abstract

Initial graft failure, especially in hearts from “marinal” or “expanded” donors, and cardiac allograft asculopathy (CAV), which develops in more than half f transplant recipients who survive beyond 3 to 5 ears, represent the major limitations for the recipients’ hortand long-term survival. The causes for both of hese pathophysiologic processes are largely undefined nd most likely multifactorial; however, activation of he allograft endothelium and the ensuing inflammatory eaction represent early events, serving as potential herapeutic targets (Figure 1). This article initially discusses the pathophysiology of ndothelial activation in cardiac allografts and then ocuses on possible therapeutic strategies to minimize he activation of the endothelium, thereby reducing the ncidence of early and late organ failure.