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Humoral rejection after heart transplantation: reliability of intramyocardial electrogram recordings (IMEG) and myocardial biopsy
- Source :
- Transplant International. 10:439-445
- Publication Year :
- 1997
- Publisher :
- Frontiers Media SA, 1997.
-
Abstract
- In recent years, as the importance of humoral-mediated rejection has increasingly become recognized, the fact that endomyocardial biopsies (BX) evaluated according to the criteria of the International Society for Heart and Lung Transplantation often produce false-negative results has become a matter of concern. To evaluate the reliability of measuring intramyocardial ECG amplitude (IMEG) and immunofluorescence evaluation (FITC-labeled anti-IgG/IgM staining) of endomyocardial biopsies (IFM), heterotopic neck-heart transplantation (HTX) was performed on eight beagles previously sensitized through skin transplantations. After HTX, IMEG, echo, and donor-specific antibodies in serum (IgG, IgM) were determined daily and myocardial biopsies (IFM, BX) were performed once every 2 days. Accelerated (humoral) rejection occurred on the 5th (4th–5th) postoperative day and sensitivity of IMEG, IFM, and BX was 100 %, 75 %, and 12.5 %, respectively. In each case rejection was recognized so early that it was possible to initiate therapy with “restitutio ad integrum”. Our results show that, as opposed to endomyocardial biopsy (IFM, BX), IMEG diagnosis detected humoral-mediated rejection early and with high reliability.
- Subjects :
- Graft Rejection
Nephrology
medicine.medical_specialty
Pathology
Time Factors
Myocardial biopsy
Biopsy
Heart Ventricles
medicine.medical_treatment
Anti-Inflammatory Agents
Immunofluorescence
Antibodies
Electrocardiography
Dogs
Postoperative Complications
Diastole
Internal medicine
Animals
Edema
Medicine
Lung transplantation
Lymphocytes
Cyclophosphamide
Heart transplantation
Transplantation
Hematology
medicine.diagnostic_test
business.industry
Myocardium
Skin Transplantation
Cortisone
Desensitization, Immunologic
Antibody Formation
Blood Component Removal
Heart Transplantation
business
Complication
Immunosuppressive Agents
Subjects
Details
- ISSN :
- 14322277 and 09340874
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Transplant International
- Accession number :
- edsair.doi.dedup.....60b60d8858687f1af8155033d96c6786