Immune monitoring of blood in heart transplant recipients: application of flow cytometry.
In this study, we review the utility of peripheral blood lymphocyte evaluation using commercially available monoclonal antibodies in the diagnosis of rejection or infection in 27 patients undergoing allograft heart transplantation. Double-color staining methods employing fluorescein isothiocyanate (FITC) and phycoerythrin (PE) allowed identification of a variety of lymphocyte subsets and determination of activation or proliferation of lymphocytes. All patients also underwent regular endomyocardial biopsy procedures. A total of 30 rejection episodes were diagnosed by endomyocardial biopsy. The results of immune monitoring profile (IMP) of lymphocytes and endomyocardial biopsies were concordant 76% of the time. Discrepancies were most common when the biopsy showed only mild rejection. The false-positive rate with serial IMP was less than 1%. The IMP was also useful in distinguishing between infection, especially cytomegalovirus infection, and rejection. General guidelines for utilizing IMP in transplant recipients are presented.
Garner
R J
RJ
Laboratory, Presbyterian Hospital, Albuquerque, NM 87125-6666.
Springgate
C
C
Hoyt
T
T
D000911:Antibodies, Monoclonal; D001706:Biopsy; D005434:Flow Cytometry; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008214:Lymphocytes / Q000145:classification; D015166:Monitoring, Immunologic / Q000379:methods*; D009206:Myocardium / Q000473:pathology
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents