Graft microvascular disease in solid organ transplantation

Xinguo Jiang, Yon K. Sung, Wen Tian, Jin Qian, Gregg L. Semenza, Mark R. Nicolls

Research output: Contribution to journalReview articlepeer-review

Abstract

Alloimmune inflammation damages the microvasculature of solid organ transplants during acute rejection. Although immunosuppressive drugs diminish the inflammatory response, they do not directly promote vascular repair. Repetitive microvascular injury with insufficient regeneration results in prolonged tissue hypoxia and fibrotic remodeling. While clinical studies show that a loss of the microvascular circulation precedes and may act as an initiating factor for the development of chronic rejection, preclinical studies demonstrate that improved microvascular perfusion during acute rejection delays and attenuates tissue fibrosis. Therefore, preservation of a functional microvasculature may represent an effective therapeutic strategy for preventing chronic rejection. Here, we review recent advances in our understanding of the role of the microvasculature in the long-term survival of transplanted solid organs. We also highlight microvessel-centered therapeutic strategies for prolonging the survival of solid organ transplants.

Original languageEnglish (US)
Pages (from-to)797-810
Number of pages14
JournalJournal of Molecular Medicine
Volume92
Issue number8
DOIs
StatePublished - Aug 2014

Keywords

  • Chronic rejection
  • Endothelial cells
  • Fibrosis
  • Graft microvascular disease
  • Transplantation

ASJC Scopus subject areas

  • Molecular Medicine
  • Drug Discovery
  • Genetics(clinical)

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