Humoral rejection after heart transplantation: reliability of intramyocardial electrogram recordings (IMEG) and myocardial biopsy
| Autor: | Fietze E, Müller Jm, Onnen Grauhan, Henryk Siniawski, R. Pfitzmann, Christoph Knosalla, Roland Hetzer, Hans-Dieter Volk |
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| Rok vydání: | 1997 |
| Předmět: |
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 |
| Zdroj: | Transplant International. 10:439-445 |
| ISSN: | 1432-2277 0934-0874 |
| DOI: | 10.1007/s001470050083 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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