Differing cellular infiltrates on serial biopsy of heart allograft recipients randomized to okt3 or hatg induction therapy: Implications for graft injury

36A

JACC Vol. 15, No. 2 ebnmy 1990:36A

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INFLUENCE OF GENDERON ALLOGFIAFT RWECTION TRANSPlANTAlloM

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M.D., Branislav Radovencevlc, M.D., Glay M. Burnett, M.D., James L Lonquist, M.D., CharlesVan Buren, M.D., F.AC.C., Rovrald H., Kennan, PhD., SinisaBobfjw, M.D., J. Michael Duncan, M.D.. F.AC.C., 0. Hward Frazier,M.D.,F.AC.C..Texas Hti Institute, Houston, TX.

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TO tsssess the bdluertce d gender on ellograft rejection and swvhai in

donor an early onset of rejection. The incidence d rejection wllhin one year after transplant was also higher if either the donw or re@ent was female. Only 188 of 172 (78%) males who had a mtlledam fe@ctedwlthin one year, while in contrast, 10 of 10 (100%)

followingthe fast episodeof histologicallyproven rejec rate.or mere) coincidentwithrestrictiveobvsioloav.

men (77%) and women (75%) who had donors of the eeme sex, compared to had donors of the oppositesex When DA matching and/or preoperative blood tched donor recipient pairs, no signtkam

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Earlyand late benefitsof inductiontherapie thosewhichemployanti-Tcell antibodies(OKD controversial.We examinedthe impactof 10 dys inductionand 14dys of HATGinductionon total cellsand cell subsetsin serial surveillanceendomyocardialbiqpsy(bx) specimensin 17 randomizeda&graft recipients(12 male,5 female;mean age 49 yrs, range 15-66).Quantitativeimmunephenotypingusingparaffin-resilient cell surfaceantibodiesto lymphocytes(LCA),T-cells(UCHLI), B cells (LX) & macroph&es (MAC387)referencedto bx surfacearea (mn?) revealed fewergraft infiltrating phocytesoverall in OKT3vs HATG pts (mean30 vs 44/mrxd =0.03),with the greatestreductionin B cells(mean5 vs IO/nut! ’ , pmO.09)accountingfor bx at 1,2,3,4 wksand 2,3,4$,6mospost= n bx specimenswithout histopathologic rejection,the total infiltrating‘cellsand cell subsetswere fewer in OKT3vs ts (31 vs 55 lymphocytes/mn?,p=O.O2);similarlyduringepisodesof treatableand non-treatable ion, the total cellsand rnacropblages were less frequentin 0 than HATGpts (137vs 298/nu& p>O.OS; 106vs 103/mt& p>O.OS).These relationspersistedover time. ‘Ibus,an early and continueddifferencein cellularinfiltratesin “quiescent” and rejectingallograftsis inducedby CKT3and HAT’Gtherapy. The implicationsfor amount,nauue and outcomeof graft injuryshouldreceivefurther study,

shaddv, M.D., CWnK. t-&k, M.D. ar14 the WSUi C&diac

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