An apparent case of undiagnosed donor K awasaki disease manifesting as coronary artery aneurysm in a pediatric heart transplant recipient

Abstract

We present a case of coronary ectasia and LAD coronary artery aneurysm with angiographic characteristics of K awasaki disease in a three‐yr‐old girl two‐yr status post‐orthotopic heart transplant. Coronary anomalies were noted during initial screening coronary angiography two yr after transplant. Subsequent review of the donor echocardiogram revealed that the LMCA had been mildly dilated prior to transplant. In the absence of any symptoms consistent with K awasaki disease in the transplant recipient, this appears to be a case of K awasaki disease in the organ donor manifesting with coronary anomalies in the transplant recipient. The patient has done well clinically, and repeat coronary angiography has revealed partial regression of coronary anomalies. Given multiple reports in the literature of persistent abnormalities of coronary artery morphology and function after K awasaki disease, close monitoring is warranted, with consideration of potential coronary protective medical therapies.