ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Follow-up of Rejection Phenomenia by Using Cytoimmunologic Monitorisation in The Heart Transplantations
Denyan MANSUROĞLU, Kaan KIRALİ, Mustafa GÜLER, Altuğ TUNCER, Ercan EREN, Esat AKINCI, Ali GÜRBÜZ, Ömer IŞIK, Cevat YAKUT
Koşuyolu Kalp ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Bölümü
The leading mortality and morbidity seeing after heart transplantation are infection and acute rejection phenomenon. Currently, the most accurate early rejection diagnostic method after cardiac transplantation is the hystopathologic analysis of the endomyocardial biopsy. However, endomyocardial biopsy has many disadvantages. For these reasons cytoimmunologic monitorization, which is a noninvasive and technically simple method correlates well with the hystopathologic findings, has gained great attention in many centers as a supportive method to endomyocardial biopsy.

Between 1989 and 1998, 13 patients underwent heart transplantation at Koşuyolu Heart and Research Hospital. There were two female and 11 male patients and their mean age was 38.5±11 years (19-58). One of them underwent heterotopic heart transplantation, and the others underwent orthotopic heart transplantation. The first orthotopic heart transplantation was followed up only with endomyocardial biopsies. The second patient was followed up with endomyocardial biopsy and cytoimmunologic monitorization. After we had seen the correlation between both techniques, the other patients were followed up only with cytoimmunologic monitarization. When acute rejection was suspected, the diagnosis was certained by performing endomyocardial biopsy and the results were compared with the other invasive and noninvasive methods. When infection was suspected, blood cultures, antibody titrations and clinical findings were searched to support the diagnosis.

According to our study, correlating with and supported by the other noninvasive methods, cytoimmunologic monitarization seems to be a reliable method for screening of rejection phenomenon and infection, and can reduce the need of endomyocardial biopsies in heart transplantant patients.

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