Noninvasive detection of rejection of transplanted hearts with indium-111-labeled lymphocytes

Howard Eisen, S. B. Eisenberg, J. E. Saffitz, R. M. Bolman, B. E. Sobel, S. R. Bergmann

Research output: Contribution to journalArticle

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Abstract

To determine whether cardiac transplant rejection can be detected noninvasively with indium-111 (111In)-labeled lymphocytes, we studied 11 dogs with thoracic heterotopic cardiac transplants without immunosuppression and five dogs with transplants treated with cyclosporine (10 mg/kg/day) and prednisone (1 mg/kg/day). All were evaluated sequentially with gamma scintigraphy after administration of 150 to 350 μCi of autologous 111In-lymphocytes. Technetium-99m-labeled red blood cells (1 to 3 mCi) were used for correction of radioactivity in the blood pool attributable to circulating labeled lymphocytes. Lymphocyte infiltration was quantified as the ratio of indium in the myocardium of the transplant or native heart compared with that in blood (indium excess, IE). Results were correlated with mechanical and electrical activity of allografts and with histologic findings in sequential biopsy specimens. In untreated dogs (n = 11), IE was 15.5 ± 7.0 (SD) in transplanted hearts undergoing rejection and 0.4 ± 1.1 in native hearts on the day before animals were killed (p < .01). In dogs treated with cyclosporine and prednisone (n = 5), IE was minimal in allografts during the course of immunosuppression (0.8 ± 0.4) and increased to 22.9 ± 11.1 after immunosuppression was stopped. Scintigraphic criteria of rejection (IE > 2 SD above that in native hearts) correlated with results of biopsies indicative of rejection and appeared before electrophysiologic or mechanical manifestations of dysfunction. Thus infiltration of labeled lymphocytes in allografts, indicative of rejection, is detectable noninvasively by gamma scintigraphy and provides a sensitive approach potentially applicable to clinical monitoring for early detection of rejection and guidance for titration of immunosuppressive measures.

Original languageEnglish (US)
Pages (from-to)868-876
Number of pages9
JournalCirculation
Volume75
Issue number4
DOIs
StatePublished - Jan 1 1987

Fingerprint

Indium
Lymphocytes
Dogs
Transplants
Radionuclide Imaging
Allografts
Biopsy
Technetium
Graft Rejection
Immunosuppressive Agents
Prednisone
Immunosuppression
Radioactivity
Cyclosporine
Myocardium
Thorax
Erythrocytes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Eisen, H., Eisenberg, S. B., Saffitz, J. E., Bolman, R. M., Sobel, B. E., & Bergmann, S. R. (1987). Noninvasive detection of rejection of transplanted hearts with indium-111-labeled lymphocytes. Circulation, 75(4), 868-876. https://doi.org/10.1161/01.CIR.75.4.868
Eisen, Howard ; Eisenberg, S. B. ; Saffitz, J. E. ; Bolman, R. M. ; Sobel, B. E. ; Bergmann, S. R. / Noninvasive detection of rejection of transplanted hearts with indium-111-labeled lymphocytes. In: Circulation. 1987 ; Vol. 75, No. 4. pp. 868-876.
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Eisen, H, Eisenberg, SB, Saffitz, JE, Bolman, RM, Sobel, BE & Bergmann, SR 1987, 'Noninvasive detection of rejection of transplanted hearts with indium-111-labeled lymphocytes', Circulation, vol. 75, no. 4, pp. 868-876. https://doi.org/10.1161/01.CIR.75.4.868

Noninvasive detection of rejection of transplanted hearts with indium-111-labeled lymphocytes. / Eisen, Howard; Eisenberg, S. B.; Saffitz, J. E.; Bolman, R. M.; Sobel, B. E.; Bergmann, S. R.

In: Circulation, Vol. 75, No. 4, 01.01.1987, p. 868-876.

Research output: Contribution to journalArticle

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