title: Single-field total lymphoid irradiation in the treatment of refractory rejection after heart transplantation.
abstract: 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.
authors.affiliation: Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Trachiotis
authors.forename: T S
authors.initials: TS
authors.lastname: Johnston
authors.forename: J D
authors.initials: JD
authors.lastname: Vega
authors.forename: I R
authors.initials: IR
authors.lastname: Crocker
authors.forename: N
authors.initials: N
authors.lastname: Chesnut
authors.forename: J F
authors.initials: JF
authors.lastname: Lutz
authors.forename: A L
authors.initials: AL
authors.lastname: Smith
authors.forename: K R
authors.initials: KR
authors.lastname: Kanter
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents