Serial monitoring of co-stimulating signals in double hand allograft: a case report.
OBJECTIVE
The aim of this study was to evaluate the clinical significance of serial monitoring of co-stimulating signals in double hand transplantation.


METHODS
From September 2001 to December 2001, a patient who had double hand transplantation in our hospital was the subject of the experiment. Before the operation, a blood sample was collected before giving an immunodepressant and twice after giving the immunodepressant. A blood sample was also collected before arteriovenous connection during the operation, as well as once a day during the first week after the operation, once every other day in the second week, twice a week in the third and fourth week, followed by once a week for 2 months. The first week after operation was taken as the induction period with the other samples as the maintenance period. Then 2 mL peripheral venous blood collected from a healthy adult was anti-coagulated using EDTA of mass scores of 20 g/L. Flow cytometry was used for serial monitoring of T-cell surface co-stimulating molecules (CD28, CD54, and CD11a).


RESULTS
The changes in the 3 co-stimulating molecules-CD28, CD54, and CD11a-were consistent with each other after double hand transplantation, displaying a decrement during induction compared with preoperatively: 9.84 +/- 5.28%, 55.50 +/- 3.62%; 71.03 +/- 5.33% versus 95.10 +/- 1.26%; 9.40 +/- 9.17%, 29.70 +/- 3.23% with low levels during maintenance 22.54 +/- 6.56%, 91.28 +/- 8.12%, 11.22 +/- 4.08%.


CONCLUSIONS
The serial monitoring of the co-stimulating signals in the peripheral blood of limb allograft patients may be beneficial to evaluate postoperative immunologic reactions to guide immunosuppression as well as predict and diagnose postoperative immune rejection.
Xiang
D-Y
DY
Department of Traumatic Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
Pei
G-X
GX