Aim of the study is to show the pathogenetic importance of myocardial revascularization and to estimate quantitatively effi ciency of the treatment of cardiac allograft vasculopathy after heart transplantation. Materials and  methods . 30 percutaneous coronary interventions (PCI) were performed to recipients of heart transplant (8 men and 7 women, aged from 18 to 56 years), who were diagnosed with cardiac allograft vasculopathy by coronary angiography within the time period from 1,5 to 12 years after heart transplantation. Before revascularization and one week after tolerances to physical activity, volume characteristics of the left ventricle were defi ned and diastolic function of heart was estimated. Average term of observation after stenting was 35,5 ± 5,5 months. Results.  Tolerance to physical activity (from 76,6 ± 8,5 to 116,9 ± 9,6 W), its duration (from 5,4 ± 2,2 to 8,5 ± 4,1 min) and rate pressure product – RPP (from 198 ± 15 to 247 ± 24 P < 0,05) increased. There was a restoration of diastolic function (Ve/Va from 0,57 ± 0,18 to 1,15 ± 0,2 P < 0,05). Signifi cant distinction in time frames of vasculopathy development, frequency and reasons of repeated interventions depending on age of patients is revealed. In the group of patients younger than 30 years of age (7 patients), the time interval between heart transplantation and vasculopathy development is twice shorter, than in more senior patient group, over 45 years old (8 patients). Young patients showed the expressed tendency to develop stent restenosis (20 coronary interventions). Conclusion.  Dynamics in functional condition of the left ventricle as a result of revascularization confi rms the leading role of miocardial ischemia in pathogenesis of transplant insuffi ciency due to vasculopathy. The signifi cant factor infl uencing upon long-term result of coronary intervention is the age of the patient.

Cytomegalovirus infection may be associated with the development of acute cellular rejection – the most fre- quent and serious complication after heart transplantation, limiting long-term survival of recipients. Biomarkers of inflammation and thrombosis, one of which is the product of platelet activation – a soluble CD40 ligand (sCD40L), also play an important role in the immunopathology of acute rejection. The aim of the study was to assess the risk of cardiovascular complications after heart transplantation under the combined effect of two factors – sCD40L and cytomegalovirus infection. We examined 64 heart recipients in the period of 12 years after heart transplantation. It was revealed that with the presence of elevated levels of sCD40L in combination with cytomegalovirus infection, risk of acute cellular rejection is higher. In recipients with low levels of sCD40L and without cytomegalovirus infection survival rate is significantly higher than in recipients with the presence of one or both of the studied risk factors.