Improved immunosuppression for cardiac transplantation: immune monitoring and individualized modulation of recipient immunity by in vitro testing.
These studies demonstrate that immune monitoring and individualized modulation of recipient immune reactivity using a quality-controlled preparation of rabbit antithymocyte globulin can improve results of cardiac transplantation. The most valuable assay in individualizing drug doses was the serial measurement of T-cell levels using a complete lymphocyte profile technique and monitoring with phytohemagglutinin to rule out false low T-cell levels. Using this system, the incidence and severity of early rejections were markedly reduced and no grafts were lost to rejection in the first month. The recent first-year graft survival has been about 60%, an improvement largely related to a reduction in early rejection and infection. This technique of immunosuppression appears quite promising for improving the results of future cardiac transplantations.
D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D003208:Concanavalin A / Q000276:immunology; D003601:Cytotoxicity Tests, Immunologic; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007158:Immunologic Techniques; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008991:Monitoring, Physiologic; D010835:Phytohemagglutinins; D012397:Rosette Formation; D013601:T-Lymphocytes / Q000276:immunology*; D013997:Time Factors; D014184:Transplantation, Homologous
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D010835:Phytohemagglutinins; D003208:Concanavalin A