Heart allograft rejection under varying immunosuppressive protocols as evaluated by endomyocardial biopsy

M. Imakita, H. D. Tazelaar, M. E. Billingham

Research output: Contribution to journalArticle

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Abstract

Rejection episodes in 259 heart allograft recipients and 29 heart-lung transplant patients at Stanford University were examined from the viewpoint of endomyocardial biopsy. The patients were divided into the following six groups of immunosuppressive regimen: Group 1 (100 patients) was treated with conventional immunosuppression. Group 2 (26 patients) was treated with cyclosporine in combination with low-dose corticosteroids and an initial 3- to 4-day course of rabbit antithymocyte globulin. Group 3 (76 patients) was treated with cyclosporine and low-dose corticosteroids. Group 4 (34 patients) was treated with low-dose cyclosporine, azathioprine,and low-dose corticosteroids. Group 5 (23 patients) was treated with low-dose cyclosporine and azathioprine, but initially without low-dose corticosteroids. Group 6 was composed of 29 heart-lung transplant recipients. Group 1, 2, and 6 had significantly less rejection episodes than group 3, and groups 4 and 5 had more rejection episodes than group 3. In patients with a diagnosis of mild acute rejection on cyclosporine, a repeat biopsy shows progression to a moderate acute rejection in 21% to 43% of cases, emphasizing the importance of this diagnosis even in cyclosporine-treated patients. The characteristics of acute heart allograftrejection as assessed by endomyocardial biopsy are important to recognize. In part as a result of the data presented here, further modifications in the immunosuppressive regimens of the Stanford heart and heart-lung transplant recipients are being undertaken.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
JournalJournal of Heart Transplantation
Volume5
Issue number2
StatePublished - 1986
Externally publishedYes

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Immunosuppressive Agents
Allografts
Biopsy
Cyclosporine
Adrenal Cortex Hormones
Azathioprine
Lung
Antilymphocyte Serum
Immunosuppression
Rabbits
Transplants

ASJC Scopus subject areas

  • Transplantation

Cite this

Heart allograft rejection under varying immunosuppressive protocols as evaluated by endomyocardial biopsy. / Imakita, M.; Tazelaar, H. D.; Billingham, M. E.

In: Journal of Heart Transplantation, Vol. 5, No. 2, 1986, p. 279-285.

Research output: Contribution to journalArticle

Imakita, M. ; Tazelaar, H. D. ; Billingham, M. E. / Heart allograft rejection under varying immunosuppressive protocols as evaluated by endomyocardial biopsy. In: Journal of Heart Transplantation. 1986 ; Vol. 5, No. 2. pp. 279-285.
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