Single-field total lymphoid irradiation in the treatment of refractory rejection after heart transplantation.
Nine heart transplant recipients were treated with single-field total lymphoid irradiation (TLI) for early (<1 year) or late (>1 year) rejection that was refractory to multiple regimens of immunosuppressive therapy. For patients with early rejection (n = 6), the rejection frequency (rejections/patient/month) decreased from pre-TLI of 1.63 to post-TLI of .02 (p < .001), and for patients with late rejection (n = 3), the rejection frequency decreased from pre-TLI of .23 to post-TLI of .05 (p < .02). The reduced rejection frequencies have been maintained for a mean follow-up of 28.6 (8 to 78) months, and adverse events during or late after TLI were uncommon. Single-field TLI is a safe and effective technique in the management of refractory rejection early or late after heart transplantation.
Trachiotis
G D
GD
Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA.
Johnston
T S
TS
Vega
J D
JD
Crocker
I R
IR
Chesnut
N
N
Lutz
J F
JF
Smith
A L
AL
Kanter
K R
KR
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000532:radiotherapy*; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015182:Lymphatic Irradiation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage
D007166:Immunosuppressive Agents