cardiac allograft vasculopathy
Also written as: CAV — cardiac allograft vasculopathy
Chronic rejection process in heart transplants characterized by concentric intimal proliferation of coronary arteries.
Full Definition
Cardiac allograft vasculopathy represents the pathologic manifestation of chronic rejection in heart transplant recipients, characterized by accelerated atherosclerosis affecting the coronary circulation of the transplanted heart. Unlike native atherosclerosis, this process involves concentric, diffuse intimal proliferation affecting both epicardial and intramyocardial vessels, often extending to the microvasculature. The lesions typically lack the eccentric, focal plaques seen in conventional atherosclerosis and do not show predilection for vessel bifurcations. This immune-mediated vasculopathy is thought to result from repeated episodes of vascular injury from rejection, infection, and other factors, leading to smooth muscle cell proliferation and extracellular matrix accumulation in the vessel intima.
Usage
Usage note: Use the current ISHLT terminology rather than older terms like 'chronic rejection'.
In Context
- "Endomyocardial biopsy revealed grade 1R acute cellular rejection with early changes of cardiac allograft vasculopathy." — Transplant pathology report
- "The coronary angiogram showed the diffuse, concentric narrowing typical of cardiac allograft vasculopathy." — Transplant cardiology note