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Doody's Review ServiceReviewer: Joseph G Rogers, M.D.(Washington University School of Medicine)
Description: This is a comprehensive review of the basic and clinical aspects of acute and chronic cardiac allograft rejection.
Purpose: The purpose is to define the immunologic principles that underlie the immune response to transplanted tissue and then translate these into the field of clinical transplantation. The editors have selected relevant topics as well as authors who have capably highlighted the state-of-the-art in cardiac rejection.
Audience: The book is best suited for individuals with either a basic or clinical interest in cardiac transplantation or the general principles responsible for rejection of transplanted solid organs.
Features: Chapters that comprehensively describe the basic functions of the immune system and the role of its various components in the development of the response to allografted tissue begin the book. Other interesting sections include the role of humoral immunity in the development of acute and chronic rejection, xenotransplantation, and the induction of tolerance to allografted tissue. The clinical aspects of human cardiac allograft rejection are covered in detail including discussions of current strategies for the detection and treatment of acute cellular and vascular rejection. A chapter from Randy Morris's laboratory focuses on the next generation of immunosuppressive agents. The final section reviews noninvasive strategies to diagnose rejection using electrocardiography, echocardiography, and nuclear scanning. There is a section of color images, many of which significantly enhance the written descriptions of observed histological changes. A few of the images, however, add little to the overall quality of the book. Readers who are less familiar with this field may have some difficulty with the early chapters that refer to varying severities of rejection without providing a reference scheme for its grading. Further, a detailed discussion of the diagnosis and management of chronic rejection is omitted.
Assessment: This is an excellent resource and review of the current knowledge base pertaining to cardiac allograft rejection. It is well written and well referenced and it should be included in the personal and academic libraries of individuals and institutions involved in cardiac transplantation.