Detection of cardiac allograft rejection using radionuclide techniques.
The results of the investigations in the search for a radionuclide technique to detect rejection have, thus far, not found any method that can be applied clinically. Functional studies are not sensitive enough, unless further work on the quantitative volume changes shows consistent correlation. "Routine" myocardial imaging agents such as 67Ga, 99TcPP, or the perfusion agent, 201Tl are clearly not specific enough to detect rejection until the grafts are nearly lost. Radiolabeled lymphocyte studies show promise, in that lymphocytes are intimately involved in the rejection process. However, there needs to be further research to determine if the specificity of the technique can isolate those patients who require treatment. The data involving labeled antimyosin antibody fragments indicate that they can specifically detect myocyte necrosis that occurs on the microscopic level. However, it may also be too sensitive a technique for transplanted hearts, which are so immunologically active at baseline to determine when treatment is necessary.
Addonizio
L J
LJ
Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY 10023.
D000818:Animals; D000911:Antibodies, Monoclonal; D003326:Coronary Circulation; D011756:Diphosphates; D005710:Gallium Radioisotopes; D015637:Gated Blood-Pool Imaging; D006084:Graft Rejection; D006321:Heart / Q000000981:diagnostic imaging*; D016027:Heart Transplantation; D006801:Humans; D007205:Indium Radioisotopes; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate; D013794:Thallium Radioisotopes
D000911:Antibodies, Monoclonal; D011756:Diphosphates; D005710:Gallium Radioisotopes; D007205:Indium Radioisotopes; D013794:Thallium Radioisotopes; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium