Interstitial leukocytes in right ventricular endomyocardial biopsies after heart transplantation in patients with complicated versus uneventful postoperative course.
BACKGROUND
Infections and rejections play key roles in morbidity and mortality in the early postoperative period after orthotopic heart transplantation (HTX). The aim of this study was to evaluate whether qualitative and quantitative analyses of various interstitial leukocytes in endomyocardial biopsies during the first 2 weeks after HTX provided early information on these complications.


METHODS
During and after HTX, endomyocardial biopsies were obtained in 51 patients. By immunohistochemistry we determined the CD3-, CD4-, CD8-, CD15-, CD20-, CD57-, and CD68-positive cell numbers projected to planimetrically measured areas. To compare morbidity in the postoperative course, the patients were subdivided into complicated versus uncomplicated after 3 months.


RESULTS
In the uncomplicated group, the cell counts of CD3-, CD8-, CD57-, and CD68-positive cells were significantly lower than in the complicated group. CD3-, CD4-, and CD8-positive cell numbers showed a significant decrease in the first week among the uncomplicated group. In the complicated group, the cell counts increased significantly in the second week. The numbers of CD57-positive cells were significantly lower during the first and second weeks among the uncomplicated group.


CONCLUSIONS
Increased T lymphocytes, natural killer cells, and macrophages observed in the second week after HTX indicated increased morbidity. A reduction in CD3-positive cells in the first week indicated a low morbidity risk; an increase indicated a higher risk.
Koch
A
A
Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany. Achim_Koch@med.uni-heidelberg.de
Feucht
S
S
Helmke
B M
BM
Dengler
T J
TJ
Haass
M
M
Sack
F-U
FU
Karck
M
M
Schnabel
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D001706:Biopsy; D017252:CD3 Complex / Q000032:analysis; D005260:Female; D016027:Heart Transplantation / Q000473:pathology*; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007962:Leukocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D011184:Postoperative Period; D016278:Ventricular Function, Right
D015703:Antigens, CD; D017252:CD3 Complex