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(Circulation. 2003;108:3056-3058.)
© 2003 American Heart Association, Inc.

Focused Perspective

Transplant Graft Vasculopathy

A Dark Side of Bone Marrow Stem Cells?

Masaaki Ii, MD, PhD; Douglas W. Losordo, MD

From the Division of Cardiovascular Research, Caritas St Elizabeth’s Medical Center, Tufts University, School of Medicine, Boston, Mass.

Correspondence to Douglas W. Losordo, MD, Caritas St Elizabeth’s Medical Center, 736 Cambridge St, Boston, MA 02135. E-mail douglas.losordo@tufts.edu

Key Words: Editorials • arteriosclerosis • endothelium • angiogenesis • transplantation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

"He hibernates in this world, and feeds on his own marrow."

— Henry David Thoreau, "A Week on the Concord and Merrimack Rivers: Sunday" (1849)

In his essay, Thoreau was romanticizing the survival skills of a poet, but his words transcend time and, according to the article by Hu et al¹ in the present issue of Circulation, can be used to anthropomorphize the "life" of an atherosclerotic plaque. Their data indicate that in addition to the therapeutic possibilities of bone marrow–derived cells, which have ignited multiple recent clinical trials, the marrow may also be the source of cells for plaque neovasculature that propels this pathological process forward.

See p 3122

Since the 1960s, transplantation of solid organs has become an increasingly successful therapy for patients suffering from end-stage organ failure. The greatest strides have been made in the short-term results of organ transplantation, due in large part to the introduction of effective immunosuppressive agents. Despite these successes, however, transplantation remains limited as a long-term treatment, the lone exception being renal tranplantation.² Chronic transplant dysfunction (CTD), which can be defined clinically as the progressive irreversible loss of graft function,³ is now recognized as the primary cause of allograft loss after the first year.⁴ CTD is associated with organ-specific histopathology but also features common histomorphological changes of vessels, most notably in kidney and heart transplants, a phenomenon that is referred to as transplant arteriosclerosis (TA).⁵

TA traditionally has been considered a chronic form of vascular rejection with concentric luminal . . . [Full Text of this Article]

Related Article:

Endothelial Replacement and Angiogenesis in Arteriosclerotic Lesions of Allografts Are Contributed by Circulating Progenitor Cells

Yanhua Hu, Fergus Davison, Zhongyi Zhang, and Qingbo Xu
Circulation 2003 108: 3122-3127. [Abstract] [Full Text]