Review
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World J Transplant. Dec 24, 2014; 4(4): 276-293
Published online Dec 24, 2014. doi: 10.5500/wjt.v4.i4.276
Diagnosis and management of coronary allograft vasculopathy in children and adolescents
Nathalie Dedieu, Gerald Greil, James Wong, Matthew Fenton, Michael Burch, Tarique Hussain
Nathalie Dedieu, Matthew Fenton, Michael Burch, Great Ormond Street Hospital for Children NHS Foundation Trust, WC1 3JH London, United Kingdom
Nathalie Dedieu, Gerald Greil, James Wong, Tarique Hussain, King’s College London, Division of Imaging Sciences and Biomedical Engineering, St Thomas Hospital, SE1 7EH London, United Kingdom
Author contributions: All authors contributed to the paper.
Correspondence to: Nathalie Dedieu, MD, King’s College London, Division of Imaging Sciences and Biomedical Engineering, St Thomas Hospital, Westminster Bridge Road, 4th Floor Lambeth wing, SE1 7EH London, United Kingdom. nathaliededieu@hotmail.com
Telephone: +44-20-71889617 Fax: +44-20-71885442
Received: June 9, 2014
Revised: August 12, 2014
Accepted: September 16, 2014
Published online: December 24, 2014
Abstract

Coronary allograft vasculopathy remains one of the leading causes of death beyond the first year post transplant. As a result of denervation following transplantation, patients lack ischaemic symptoms and presentation is often late when the graft is already compromised. Current diagnostic tools are rather invasive, or in case of angiography, significantly lack sensitivity. Therefore a non-invasive tool that could allow early diagnosis would be invaluable.This paper review the disease form its different diagnosis techniques,including new and less invasive diagnostic tools to its pharmacological management and possible treatments.

Keywords: Cardiac transplantation, Allograft vasculopathy, Paediatrics, Diagnosis, Management which reflect the content of the study

Core tip: Coronary allograft vasculopathy remains the leading cause of great loss in children after the first year post transplant. This paper offers a state of the art review of the disease from diagnosis including most recent and less invasive tools to management.