Phenotype of endomyocardial biopsy-derived T-lymphocyte cultures and chronic rejection after heart transplantation.
Chronic rejection (CR) is a major problem in long-term survival in heart transplantation. We analysed whether the occurrence of CR correlates with the incidence of acute rejections (AR) or with characteristics of endomyocardial biopsy-derived cell cultures. CR was diagnosed by annual angiography and defined as all coronary vascular changes. One year after transplantation 24 of the 63 patients had CR (38%). The incidence of AR in CR+ and CR- patients was comparable. The patients in both groups had similar individual median percentages of EMB-yielding cell cultures. During the first year the CR- patients had more cultures in which at least 60% of the cells were CD4+ T cells (50% vs 37%, P = 0.05), due to a stronger CD4 predominance in the first 6 months. In the second year the CD4 predominance in the patients diagnosed as CR+ after 1 year tended to be higher (P = 0.08). The patients had comparable percentages of cultures predominated by CD8+ T cells, gammadelta T cells or NK cells, irrespective of the time interval. These results might indicate that CD4+ T lymphocytes play a dual role in the aetiology of CR.
Groeneveld
K
K
Department of Internal Medicine I, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Balk
A H
AH
Ouwehand
A J
AJ
Loonen
E H
EH
v d Linden
M
M
Strikwerda
S
S
Mochtar
B
B
Jutte
N H
NH
Weimar
W
W
D000328:Adult; D001706:Biopsy; D001803:Blood Transfusion; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology*; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D007959:Lymphocyte Culture Test, Mixed; D008875:Middle Aged; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000473:pathology*; D014184:Transplantation, Homologous