Surrogate markers for late cardiac allograft survival

Mandeep R. Mehra, Ray Benza, Mario C. Deng, Stuart Russell, Steven Webber

Research output: Contribution to journalArticlepeer-review


While no definite well-validated surrogate marker for late cardiac allograft outcome is available, the early detection of cardiac allograft vasculopathy represents the 'key' candidate as an effective surrogate. Intravascular ultrasound detected intimal thickening has been noted to possess prognostic capability despite the presence of a normal coronary angiogram. Several prospective investigations have pointed to accurate thresholds of intimal thickening that are prognostically relevant and predict not only future angiographic disease but also hard allograft related endpoints including ischemic cardiac events, allograft failure, and death. Because of the resolution of intravascular ultrasound, this technique accords reproducibility and the ability to standardize the degree of intimal thickening over time. Other candidates that may serve as surrogates once appropriately evaluated include measures of allograft pump function, intragraft histology, and peripheral markers including but not limited to structural proteins (cardiac specific troponins), inflammatory markers (CRP), fibrogenic markers (TGF-beta, fibroblast growth factor), and immune markers (anti-HLA Ab and indirect alloantibodies).

Original languageEnglish (US)
Pages (from-to)1184-1191
Number of pages8
JournalAmerican Journal of Transplantation
Issue number7
StatePublished - Jul 2004
Externally publishedYes


  • Diagnostic techniques
  • Heart transplant
  • Intravascular ultrasound
  • Molecular markers
  • Outcomes
  • Rejection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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