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

What condition is characterized by vasculopathy and accelerated arteriosclerosis in chronic heart transplant rejection?

1. Bronchiolitis obliterans

2. Vanishing bile duct syndrome

3. Interstitial fibrosis

4. Accelerated arteriosclerosis

The correct answer is: Accelerated arteriosclerosis

The condition characterized by vasculopathy and accelerated arteriosclerosis in chronic heart transplant rejection is known as accelerated arteriosclerosis. This phenomenon is particularly relevant in the context of transplant medicine, as it describes the changes that can occur in the blood vessels, leading to a progressive thickening and narrowing. In chronic heart transplant rejection, the immune system's response to the foreign tissue can lead to a process called allograft vasculopathy, resulting in structural changes in the coronary arteries of the transplanted heart. This condition poses a significant risk for cardiac ischemia and graft dysfunction. Over time, these vascular changes are akin to those seen in atherosclerosis, however, they occur more rapidly and can lead to a higher incidence of cardiac events compared to non-transplanted individuals. The other options, while related to transplant complications, do not specifically address the combination of vasculopathy and accelerated arteriosclerosis. Bronchiolitis obliterans is primarily a lung-related complication associated with airway injury, vanishing bile duct syndrome is a liver-related condition usually not connected to vasculopathy in the context of heart transplantation, and interstitial fibrosis refers to scarring within the heart muscle which does not encompass the vascular changes seen in accelerated arteriosclerosis.