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Coronary allograft vasculopathy is the leading cause of morbidity and mortality among pediatric heart transplant recipients and faces unsuccessful treatment for prevention and management. Post-transplant immunosuppressive therapy has been modified over the years to determine the most effective regimen for rejection. Tacrolimus has been the superior immunosuppressant used for rejection since the early 2000s. It has been shown to have substantial immunosuppressive effects, least number of adverse effects, and decreased comorbidities compared to other regimens. Despite these advantages, CAV is still prevalent. Heart retransplantation is currently the only curative treatment. We used Google Scholar, PubMed, ClinicalKey, ScienceDirect, Elsevier, Wiley Online Library, and National Library of Medicine to compare current data on heartconserving measures and heart retransplantation for CAV in the pediatric population. New drugs have become available that bear comparison with tacrolimus, such as everolimus (EVL) and sirolimus. These drugs are shown to be more effective in preventing and managing CAV than tacrolimus long-term. Incorporating widely known drugs, such as statins and aspirin, into regimens have been observed to have no effect on chronic rejection. Advanced technology has produced drug-eluting stents small enough for pediatric patients for short-term use as restenosis is inevitable. Heart retransplantation is inferior to heart-conserving measures as complications decrease life expectancy significantly more.


Physician Assistant Studies

Degree Name

Master of Physician Assistant Studies (MPAS)

Date of Work


First Advisor

Andvik, Vicki

Publication Date

Summer 2024


Medicine and Health Sciences

Comparing the Efficacy of Heart-Conserving Measures and Retransplantation for Chronic Rejection in the Pediatric Population