title: Pilot study of low-dose azathioprine in presensitized patients awaiting heart or lung transplantation.
abstract: In an effort to reduce the level of presensitization in patients on our heart and lung transplant waiting list, ten patients with random panel reactivity above 10% on monthly screening for durations of 2 to 59 months were given low-dose azathioprine (25 to 75 mg/day) for 1 to 22 months. All patients had positive T-cell panel reactivity (10% to 70%) against specific (n = 6), multi-specific (n = 1), or undefined (n = 3) HLA loci, and four additional patients had positive B-cell panel reactivity (5% to 40%). No effect of azathioprine on panel reactivity was seen in four of ten patients (40%), whereas a significant and sustained reduction in panel reactivity occurred in six patients (60%), all within 2 months of commencing azathioprine. All nonresponders had antibodies with class I (A locus) specificity, whereas all six responders had multi-specific or undefined antibody specificities. A formal trial of low-dose azathioprine in presensitized recipients is warranted.
authors.affiliation: Cardiopulmonary Transplant Unit, St. Vincent's Hospital, Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Keogh
authors.forename: P
authors.initials: P
authors.lastname: Spratt
authors.forename: P
authors.initials: P
authors.lastname: Macdonald
authors.forename: A
authors.initials: A
authors.lastname: Glanville
authors.forename: A
authors.initials: A
authors.lastname: Kaan
authors.forename: T
authors.initials: T
authors.lastname: Doran
mesh_terms: D000328:Adult; D000961:Antilymphocyte Serum / Q000032:analysis / Q000276:immunology*; D001379:Azathioprine / Q000008:administration & dosage*; D001402:B-Lymphocytes / Q000276:immunology; D005260:Female; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007114:Immunization; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D001379:Azathioprine