Circulation, Vol 82, 2100-2107, Copyright © 1990 by American Heart Association
M Ballester, D Obrador, I Carrio, JM Auge, C Moya, G Pons-Llado and JM Caralps- Riera
The long-term clinical course and results of biopsies in 21 patients
studied with monoclonal antimyosin antibodies more than 12 months after
heart transplantation according to the presence and degree of
antimyosin-antibody uptake is described. Eighteen men and three women aged
20-52 years (39 +/- 9 years) were studied with antimyosin antibodies 12-40
months (mean, 22 +/- 9 months) after heart transplantation, and followed
for a mean of 18 months (10-28 months). The number of biopsies performed
during follow-up was 102. Results showed normal antimyosin-antibody studies
in nine patients and abnormal studies in 12 patients. Myocyte damage was
identified in 18 of the 102 biopsies (17.6%), one in the normal
antimyosin-antibody group of patients and 17 in those patients with
myocardial antimyosin-antibody uptake. Patients who developed rejection
comprised 11% and 67% of each respective group; the mean number of
rejection episodes per patient was 0.11 +/- 0.33 and 1.41 +/- 1.41,
respectively (p less than 0.01). A trend was noted by which higher
heart-to-lung ratios were associated with greater probability of rejection.
Conclusively, 1) antimyosin- antibody studies performed after more than 1
year after heart transplantation indicate the presence and level of
rejection activity, 2) groups of patients at risk for developing rejection
at biopsy during long-term follow-up may be detected by antimyosin-antibody
study, and 3) surveillance for rejection and the degree of
immunosuppression should be tailored to meet individual patient needs.
ARTICLES
Indium-111-monoclonal antimyosin antibody studies after the first year of heart transplantation. Identification of risk groups for developing rejection during long-term follow-up and clinical implications
Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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