Pathogenesis of cardiac graft failure in children

Jenny Lin, Bahig M. Shehata

Department of Pathology, Children’s Healthcare of Atlanta, Atlanta, USA.

DOI: 10.4236/ojped.2012.24051                

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.

Keywords

Cardiac Graft Failure; Pediatric Cardiac Transplant

Conflicts of Interest

The authors declare no conflicts of interest.

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