Heart transplantation has evolved as the most definitive therapy for end-stage heart failure. However, acute rejection and infection in early postoperative period and vasculopathy in following years have limited the outcome of these patients. It is important to recognize and treat these complications in the early period to improve survival. Although invasive tests are being used to establish the diagnosis, noninvasive tests like echocardiography may provide useful information in the follow-up of the patients. New echocardiographic methods such as tissue Doppler imaging (TDI), stress echocardiography and integrated backscatter (IBS) have shown to be helpful in detecting acute rejection. In this review, we aim to provide information regarding routine echocardiographic characteristics of a transplanted heart and about the use of echocardiography in the follow-up and diagnosis of complications.
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