A 55-year-old man with idiopathic dilated cardiomyopathy receives a heart transplant. Which of the following is the most likely cause of death in this patient 2 years after transplantation?

Chronic vascular rejection, also referred to as accelerated coronary artery disease, is the most common cause of death in heart transplant patients after the first year of transplantation. It usually affects the proximal and distal coronary arteries and their penetrating branches. Microscopically, the disorder is characterized by concentric intimal proliferation, leading to occlusion and myocardial infarction. This complication is painless because the transplanted heart is denervated. Acute cellular graft rejection (choice A) occurs during the first few months after transplantation, and hyperacute graft rejection (choice D) occurs quickly after transplantation.Diagnosis: Coronary artery disease