Noninvasive assessment of treatment of cardiac allograft rejection with indium-111-labeled lymphocytes

Journal Article · Thu Sep 01 00:00:00 EDT 1988 · Transplantation; (United States)

DOI:https://doi.org/10.1097/00007890-198809000-00002· OSTI ID:6746021

Rosenbloom, M; Eisen, H J; Laschinger, J; Saffitz, J E; Sobel, B E; Bergmann, S R; Bolman, III, R M

We have shown previously that cardiac allograft rejection can be detected noninvasively with gamma scintigraphy after administration of indium-111 (111In)-labeled lymphocytes. To determine whether this technique could be used to monitor salvage immunosuppressive therapy in reversing rejection, 5 dogs were studied after thoracic heterotopic cardiac transplantation. Initial postoperative immunosuppression was maintained with cyclosporine (10-20 mg/kg/day) and prednisone (1 mg/kg/day) for 7 days after transplantation and then discontinued. Scintigraphy after administration of labeled lymphocytes was performed during initial immunosuppression and every 3 days after its termination. Endomyocardial biopsies were obtained on each day scintigraphy was performed. Once scintigraphic criteria for rejection were met (111In-lymphocyte uptake greater than mean +/- 2SD of normal myocardium), animals were treated with high dose methylprednisolone and cyclosporine. Myocardial 111In-lymphocyte activity compared with that in blood was 0.7 +/- 0.8 during initial immunosuppression, increased to 5.7 +/- 3.5 after termination of therapy (P less than 0.01), and diminished with salvage immunosuppressive therapy to 0.5 +/- 0.8 (P = NS compared with native hearts or allografts during initial immunosuppression). Scintigraphy accurately predicted all but one episode of biopsy-documented rejection and accurately detected reversal of rejection during salvage. Thus, scintigraphy with 111In-labeled lymphocytes should facilitate noninvasive monitoring of antirejection therapy in patients.

• Research Organization: Washington Univ. School of Medicine, St. Louis, MO (USA)
• OSTI ID: 6746021
• Journal Information: Transplantation; (United States), Vol. 46:3
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
GRAFT-HOST REACTION
DIAGNOSIS
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LABELLING
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IMMUNOSUPPRESSION
IMMUNOSUPPRESSIVE DRUGS
INDIUM 111
PREDNISONE
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ADRENAL HORMONES
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DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GLUCOCORTICOIDS
HYDROXY COMPOUNDS
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
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MINUTES LIVING RADIOISOTOPES
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550601* - Medicine- Unsealed Radionuclides in Diagnostics