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Right arrow Transplantation - heart

Ann Thorac Surg 2001;72:735-739
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Importance of thymus to maintain operational tolerance to fully allogeneic cardiac grafts

Masanori Niimi, MD, PhDa, Nozomu Shirasugi, MDa, Yosifumi Ikeda, MDa, Shigenao Kan, MDa, Hiroshi Takami, MDa, Kimikazu Hamano, MD, PhDb

a First Department of Surgery, Teikyo University, Tokyo, Japan
b First Department of Surgery, Yamaguchi University, Yamaguchi, Japan

Accepted for publication May 16, 2001.

Address reprint requests to Dr Niimi, First Department of Surgery, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
e-mail: mniimi{at}med.teikyo-u.ac.jp

Background. The effectiveness of donor-specific blood transfusion (DST) before transplantation has been established. Anti-CD4 monoclonal antibody (anti-CD4) augments the ability of DST to induce indefinite prolongation. Therefore, we investigated the importance of thymus to maintain the unresponsiveness to alloantigens.

Methods. CBA mice were pretreated with 0.25 mL of DST or two doses of anti-CD4 before transplantation of a C57BL/10 heart. Some mice were thymectomized.

Results. Naive CBA mice rejected C57BL/10 grafts acutely with a median survival time of 7 days. When mice were pretreated with anti-CD4 plus DST 4 weeks before transplantation, all grafts survived indefinitely (>100 days), whereas mice treated with DST alone or anti-CD4 alone rejected acutely (median survival time, 7 and 12 days, respectively). To investigate the importance of thymus, mice pretreated with anti-CD4 plus DST 4 weeks before transplantation were thymectomized or underwent a sham operation 1 day before grafting. Mice with the sham operation accepted grafts indefinitely, whereas thymectomized mice rejected the majority of the grafts (median survival time, 20 days).

Conclusions. The thymus is important in maintaining the operational tolerance induced by anti-CD4 plus DST 4 weeks before grafting.






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