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Ann Thorac Surg 1979;28:212-223
© 1979 The Society of Thoracic Surgeons

Articles

Improved Immunosuppression for Cardiac Transplantation: Immune Monitoring and Individualized Modulation of Recipient Immunity by In Vitro Testing

F.T. Thomas, M.D.*, S.S. Szentpetery, M.D., T.C. Wolfgang, M.D., J.E. Quinn, M.D., J. Thomas, Ph.D., R.R. Lower, M.D.

From the Department of Surgery and Medicine, Medical College of Virginia, Richmond, VA.

* Address reprint requests to Dr. F. T. Thomas, Department of Surgery, East Carolina School of Medicine, Greenville, NC 27834.

These studies demonstrate that immune monitoring and individualized modulation of recipient immune reactivity using a quality-controlled preparation of rabbit antithymocyte globulin can improve results of cardiac transplantation. The most valuable assay in individualizing drug doses was the serial measurement of T-cell levels using a complete lymphocyte profile technique and monitoring with phytohemagglutinin to rule out false low T-cell levels. Using this system, the incidence and severity of early rejections were markedly reduced and no grafts were lost to rejection in the first month. The recent first-year graft survival has been about 60%, an improvement largely related to a reduction in early rejection and infection. This technique of immunosuppression appears quite promising for improving the results of future cardiac transplantations.






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Copyright © 1979 by The Society of Thoracic Surgeons.