2002 Fiscal Year Final Research Report Summary
Biological monitoring of immunological modifications in patients supported with left ventricular assist system
| Project/Area Number |
13671387
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Osaka University |
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Principal Investigator |
MATSUMIYA Goro Osaka Univ., Graduate School of Med, Assistant Professor, 医学系研究科, 助手 (20314312)
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| Co-Investigator(Kenkyū-buntansha) |
SAKAKIDA Satoru Osaka Univ., Graduate School of Med, Associate Professor, 医学系研究科, 助教授 (90311753)
FUKUSHIMA Norihide Osaka Univ., Graduate School of Med, Assistant Professor, 医学系研究科, 助手 (30263247)
SAWA Yoshiki Osaka Univ., Graduate School of Med, Associate Professor, 医学部付属病院, 助教授 (00243220)
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| Project Period (FY) |
2001 – 2002
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| Keywords | left ventricular assist system / panel reactive antibody / heart transplantation / humoral rejection / hyper cytokinemia / allo-reactive antibody |
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| Research Abstract |
We investigated a total of 30 patients with end-stage heart failure awaiting heart transplantation. Age ranged between 7 and 54, mean of 32.9. Twenty seven patients were male and 3 were female. Among them, 15 underwent the implantation of left ventricular assist system. Anti-T and B cell antibodies against pooled panel cells from Japanese population were measured in these patients. Serum IL-6 and IL-8 level were also examined. As the antibodies against HLA class-I are known to have close relations with post-transplant rejections, the changes of the anti-T antibodies and clinical courses were analyzed. Anti-T cell antibody level became positive in 4 of 15 patients (26.7%) with LVAS and 2 of 15 patients (13.3%) without LVAS. One of 2 patients without LVAS and with positive T cell Abs received heart transplantation successfully and underwent no significant rejection episodes. The other patients continued to have positive T cell Ab level for more than a year, therefore received immunosuppressive therapy with cyclophosphamide. His Ab level dropped significantly and awaiting heart transplantation. Two LUAS patients with positive T cell Abs experienced spontaneous decrease of Ab level. One patient, who also had spontaneous decrease of Ab level underwent heart transplantation. Although direct cross-match was negative, he experienced severe humoral rejection a week after the transplant. Plasma exchange and intense immunosuppressive therapy successfully control this rejection episode. Significant elevation, of the level of anti-donor spleen cell antibodies were detected. The other LVAS patient had a complicated course with persistent infectious complications and expired from infectious endocarditis. His anti-T cell Ab level, serum IL-6 and IL-8 level were persistently high, suggesting hyper-cytokinemia may play a role in enhancing a production of all-antibodies
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