title: Serum vascular endothelial growth factor as a surveillance marker for cellular rejection in pediatric cardiac transplantation.
abstract: BACKGROUND
  Early detection and treatment of acute rejection in cardiac transplant recipients significantly improves long-term survival. Endomyocardial biopsy is used routinely for diagnosing allograft rejection; however, in young children, this procedure carries some risk. We evaluated serum vascular endothelial growth factor (VEGF) as a potential surveillance marker of acute cellular rejection.
  
  
  METHODS
  Blood samples (n=62) were analyzed from 23 patients and compared with controls (n=18) using an ELISA for VEGF. Results were correlated with endomyocardial biopsy rejection grades.
  
  
  RESULTS
  Mean baseline VEGF levels of the transplant population were consistently higher than controls. Serum VEGF levels were significantly higher during acute cellular rejection when compared with the non-rejecting transplant group (700.7+/-154 pg/ml vs. 190.5+/-29 pg/ml). VEGF decreased two- to eightfold after immunosuppressive therapy in 9 of 11 rejection episodes.
  
  
  CONCLUSIONS
  These data suggest that VEGF may play a role in the pathogenesis of acute allograft rejection and it may serve as a reliable serologic surveillance marker.
authors.affiliation: Department of Pediatric Surgery, Children's Memorial Hospital, Northwestern University Medical School, Chicago, IL 60611, USA.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Abramson
authors.forename: Elfriede
authors.initials: E
authors.lastname: Pahl
authors.forename: Lijun
authors.initials: L
authors.lastname: Huang
authors.forename: Veronica
authors.initials: V
authors.lastname: Stellmach
authors.forename: Sherrie
authors.initials: S
authors.lastname: Rodgers
authors.forename: Constantine
authors.initials: C
authors.lastname: Mavroudis
authors.forename: Carl L
authors.initials: CL
authors.lastname: Backer
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arensman
authors.forename: Susan E
authors.initials: SE
authors.lastname: Crawford
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D016228:Endothelial Growth Factors / Q000097:blood*; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007223:Infant; D008222:Lymphokines / Q000097:blood*; D012016:Reference Values; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D015415:Biomarkers; D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors