Clinical heart transplantation. Total lymphoid irradiation for resistant rejection after heart transplantation: only moderate success medium-term.
Total lymphoid irradiation (640 cGy) was given to 19 heart and 1 heart-lung recipients on maintenance triple therapy at a mean of 4.9 +/- 4 months after transplantation (range 46 to 519 days). Mean number of treated rejection episodes before, during, and after total lymphoid irradiation was 6.4 +/- 1.7, 0.8 +/- 1.2, and 1.2 +/- 1.3 episodes per patient, respectively. During total lymphoid irradiation, 37% had at least one episode of rejection requiring treatment; after total lymphoid irradiation, 42% had no further rejection episodes, 21% had one further episode, and 37% had 2 or more episodes. Metastatic squamous cell carcinoma in one patient and coronary artery disease in three of five patients studied to date is of concern and requires longer follow-up.
Keogh
A
A
Heart and Lung Transplant Unit, Victor Chang Research Institute, Darlinghurst, Sydney, Australia.
Morgan
G
G
Macdonald
P
P
Spratt
P
P
Mundy
J
J
McCosker
C
C
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality / Q000532:radiotherapy*; D016027:Heart Transplantation / Q000276:immunology*; D016041:Heart-Lung Transplantation / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology / Q000528:radiation effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015182:Lymphatic Irradiation; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D016019:Survival Analysis
D007166:Immunosuppressive Agents