Heart-transplanted patients in Norway undergo annual coronary angiography (CA). The aims of this study were to establish a conversion factor between dose-area product and effective dose for these examinations and to use this to evaluate the accumulated radiation dose and risks associated with annual CA. An experienced cardiac interventionist performed a simulated examination on an Alderson phantom loaded with thermoluminescence dosemeters. The simulated CA examination yielded a dose-area product of 17 Gy cm(2) and an effective dose of 3.4 mSv: the conversion factor between dose-area product and effective dose was 0.20 mSv Gy cm(-2). Dose-area product values from 200 heart-transplanted patients that had undergone 906 CA examinations between 2001 and 2008 were retrieved from the institutional database. Mean dose-area product from annual CA was 25 Gy cm(2), ranging from 2 to 140 Gy cm(2). Mean number of CA procedure was 8 (range, 1-23). Mean accumulated effective dose for Norwegian heart-transplanted patients between 2001 and 2008 was 34 mSv (range, 5-113 mSv). Doses and radiation risks for heart-transplanted patients are generally low, because most heart transplantations are performed on middle-aged patients with limited life expectancy. Special concern should however be taken to reduce doses for young heart-transplanted patients who are committed to lifelong follow-up of their transplanted heart.
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http://dx.doi.org/10.1093/rpd/ncr311 | DOI Listing |
Hum Immunol
December 2024
Department of Clinical Immunology, Aarhus University Hospital, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark. Electronic address:
Genomic collision at the LIM and senescent cell antigen-like-containing domain protein 1 (LIMS1) locus between donor and heart recipient was examined for the association with diagnosis of acute cellular or antibody-mediated allograft rejection, ACR or ABMR, respectively. In this single center retrospective study, 129 heart transplanted patients and donors were genotyped for the LIMS1 rs893403 variant, where the G-allele is in almost complete linkage disequilibrium with a loss of function deletion. A total of 14 cases with genomic collision (recipient genotype GG and donor genotype AA/AG) were identified.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Background: Early detection of cardiac allograft vasculopathy after heart transplant (HTx) with invasive coronary angiography is challenging.
Aims: The study aimed to determine if computational techniques able to assess epicardial lesions, by means of Murray's law-based quantitative flow ratio (μFR), and microvascular physiology, by means of angiography microvascular resistance (AMR), enhance risk stratification in HTx patients with nonsignificant coronary artery disease.
Methods: The cohort consisted of 86 consecutive HTx patients (200 epicardial vessels) with stenosis < 50% at baseline.
Physiol Res
November 2024
Dept Cardiovasc Surgery, Inst Clin Exp Med, Prague, Czech Republic.
An important complication of prolonged support of the left ventricle with an assist device when implanted in patients with heart failure is unloading-induced cardiac atrophy. Our recent study suggested that sex-linked differences in the development of atrophy induced by heterotopic heart transplantation (HTX) do exist, however, the role of the environmental conditions dependent on plasma concentrations of sex hormones remains elusive. We aimed to compare the course of HTX-induced cardiac atrophy in male and female rats after gonadectomy with substitution of steroid hormones of the opposite sex.
View Article and Find Full Text PDFFront Transplant
September 2024
German Academy for Transplantation Medicine, Munich, Germany.
Walter Brendel was a physiologist who headed the Institut of Experimental Surgery at the University of Munich (LMU) from 1961 until 1989. His legendary career began with the development of an anti-human lymphocyte globulin (ALG) at his Institute during the late 1960s. The initial successful treatment of a small number of patients culminated in the co-treatment of the first successfully heart-transplanted patient in Capetown, South Africa (successful reversal with ALG of an acute allograft rejection).
View Article and Find Full Text PDFTransplant Direct
October 2024
Pediatric and Congenital Cardiac Surgery Department, Regina Margherita Children's Hospital, Torino, Italy.
Background: Endomyocardial biopsy (EMB) is considered the gold-standard method to diagnose rejection after heart transplantation. However, the many disadvantages and potential complications of this test restrict its routine application, particularly in pediatric patients. Donor-derived cell-free DNA (dd-cfDNA), released by the transplanted heart as result of cellular injury, is emerging as a biomarker of tissue damage involved in ischemia/reperfusion injury and posttransplant rejection.
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