Abstract
Background and Hypothesis: 
 Worldwide, approximately 650 pediatric heart transplants occur annually. Coronary artery vasculopathy (CAV) is the foremost cause of allograft failure following heart transplantation, accounting for more than 25% of deaths within one-year post transplant. Within 10 years, 30-45% of children will be diagnosed with CAV, yet the mechanism of disease is still misunderstood. Endothelin-1 (ET-1) has been shown to play an important role in development and promotion of CAV, however no studies have evaluated ET-1 levels in the pediatric population following heart transplant. 
 
 Methods: 
 All patients enrolled in the study have underwent cardiac transplant and present for annual cardiac catheterization and blood draw, with data being stored in a REDCAP database. Centrifuged plasma will be analyzed for ET-1 levels and compared to accepted standard pediatric values. Relationships between ET-1 levels and other lab values will be evaluated for correlation. 
 
 Results: 
 Currently awaiting plasma results. 
 
 Conclusion and Potential Impact: 
 This study will establish ET-1 levels in pediatric patients post cardiac transplantation. If ET-1 levels are correlated with CAV severity and are increased, ET-1 levels have the potential to be an inexpensive and easily available biomarker for continuing to monitor CAV progression. Using currently available ET-1 therapies such as ERAs has the potential to lower morbidity and mortality rates by delaying or reducing re-transplantation in patients with CAV.
Highlights
Background and HypothesisWorldwide, approximately 650 pediatric heart transplants occur annually
Coronary artery vasculopathy (CAV) is the foremost cause of allograft failure following heart transplantation, accounting for more than 25% of deaths within one-year post transplant
Within 10 years, 3045% of children will be diagnosed with CAV, yet the mechanism of disease is still misunderstood
Summary
Background and Hypothesis: Worldwide, approximately 650 pediatric heart transplants occur annually. Coronary artery vasculopathy (CAV) is the foremost cause of allograft failure following heart transplantation, accounting for more than 25% of deaths within one-year post transplant.
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