Cardiac Allograft Vasculopathy

CAV develops through endothelial dysfunction and chronic inflammation that lead to donor coronary artery intimal thickening. Cardiac allograft vasculopathy is the dominant cause of death in paediatric heart transplant recipients more than three years after transplant. Established CAV is difficult to treat because current risk-factor management and immunosuppression do not reverse lesions. Re-transplantation is described as the only definitive therapy for CAV, but it is not always feasible.