Cardiac lymphatic interruption is a major cause for allograft failure after cardiac transplantation.

ABSTRACT

Cardiac transplantation is one of the most effective treatments of end stage heart failure to date, although it comes with risks. One of the major complications of cardiac transplantation is allograft failure, which is caused by ischemic injuries, pulmonary hypertension and chronic rejection. Recent animal and human studies have demonstrated that cardiac lymphatic obstruction leads to significant myocardial fibrosis and depression in contractile forces. We hypothesize that lymphatic interruption, which is almost inevitable after cardiac transplantation, is a major cause of cardiac allograft failure through direct damages to the myocardium and also through the formation of allograft coronary vasculopathy.