American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What complication is commonly observed in patients undergoing heart transplantation?

1. Vanishing bile duct syndrome

2. Bronchiolitis obliterans

3. Interstitial fibrosis

4. Accelerated arteriosclerosis

The correct answer is: Accelerated arteriosclerosis

In patients undergoing heart transplantation, accelerated arteriosclerosis is commonly observed as a post-transplant complication. This condition involves the rapid progression of atherosclerosis in the coronary arteries, leading to allograft vasculopathy. It is characterized by the thickening of the arterial walls, which can ultimately result in graft dysfunction or failure. The mechanism behind accelerated arteriosclerosis in heart transplant patients is believed to be multifactorial, involving both immunological factors due to chronic rejection and non-immunological factors such as risk factors associated with traditional atherosclerosis, as well as the effects of immunosuppressive therapy. Speeding up the atherosclerotic process is particularly concerning because it can lead to significant morbidity and mortality in this patient population. Recognizing and managing risk factors, as well as monitoring for coronary allograft vasculopathy, is essential for the long-term care of heart transplant recipients to improve their outcomes. Other potential complications, such as bronchiolitis obliterans, interstitial fibrosis, and vanishing bile duct syndrome, may occur in different contexts or types of transplants but are not as directly associated with heart transplantation as accelerated arteriosclerosis. This highlights the unique challenges faced by patients who receive heart transplants and