The role of echocardiography in evaluation of the cardiac transplant recipient.

Echocardiography is an important tool in the management of cardiac transplant recipients. It provides comprehensive information about allograft structure and function without exposing the recipient to the risks associated with invasive investigations. Imaging can be performed in the early in-hospital phase and easily repeated during follow-up for the purposes of screening or for assessing the progression of specific pathology. When interpreting studies it is important to be aware that characteristic normal findings may be quite different from the non-transplant population. Endomyocar-dial biopsy remains the gold standard for the detection of acute allograft rejection. Doppler echocardiography has traditionally formed the basis for non-invasive diagnosis of this important complication but has recognised limitations. Advances in echocardiographic techniques indicate a potential important role for the reliable detection of rejection by this modality in the future. A range of other complications can be evaluated by echocardiography. There has been considerable recent interest in assessment of cardiac allograft vasculopathy by stress-imaging methods.