The leading cause of long term graft loss in heart and kidney transplants is an obliterative arteriopathy that has traditionally been referred to as chronic rejection [1-5]. This term is based on the premise that this disease is due almost exclusively to chronic alloimmune response to the donor. Support for this hypothesis comes from both animal and clinical data including the observation that the disease can be produced in various animal models [6-10], largely rodent, with increasing extent of disease with wider HLA mismatch [4], and no disease in syngeneic grafts.

Keywords: chronic rejection, Arteriosclerosis, Heart Transplantation