Mechanisms of chronic rejection in cardiothoracic transplantation

Matthew J. Weiss, Joren C. Madsen, Bruce R. Rosengard, James S. Allan

Research output: Contribution to journalReview articlepeer-review


Despite significant improvements in early post-transplantation survival rates, long-term patient and graft survival have remained poor, due in large part to the vexing problem of chronic allograft rejection. Attempts to combat this problem with intensification of immunosuppression have led to concomitant increases in the rates of fatal malignancies and infections. In cardiac transplantation, chronic rejection is manifested primarily by a disease entity known as cardiac allograft vasculopathy, an occlusive narrowing of the coronary vessels. In lung transplantation, chronic rejection is typified by obliterative bronchiolitis, an airflow limiting narrowing of the bronchioles. From an immunologic standpoint, chronic rejection is believed to be the end result of repeated immune and non-immune insults to the graft. This review examines the pathophysiology of heart and lung chronic, with emphasis on both immune and non-immune causes.

Original languageEnglish (US)
Pages (from-to)2980-2988
Number of pages9
JournalFrontiers in Bioscience
Issue number8
StatePublished - 2008
Externally publishedYes


  • Chronic rejection
  • Heart
  • Lung
  • Review
  • Transplantation

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)


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