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

Journal Article · · Transplantation; (United States)
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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), Journal Name: Transplantation; (United States) Vol. 46:3; ISSN TRPLA
Country of Publication:
United States
Language:
English

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Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ADRENAL HORMONES
ANIMAL CELLS
ANIMALS
BETA DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARDIOVASCULAR SYSTEM
CONNECTIVE TISSUE CELLS
CORTICOSTEROIDS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DOGS
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GLUCOCORTICOIDS
GRAFT-HOST REACTION
HEART
HYDROXY COMPOUNDS
IMMUNOSUPPRESSION
IMMUNOSUPPRESSIVE DRUGS
INDIUM 111
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KETONES
LABELLING
LEUKOCYTES
LYMPHOCYTES
MAMMALS
MATERIALS
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PREDNISONE
PREGNANES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SOMATIC CELLS
STEROIDS
TRANSPLANTS
VERTEBRATES