Elevated soluble interleukin-2 receptor levels early after heart transplantation and long-term survival and development of coronary arteriopathy

J. B. Young, K. S. Lloyd, N. T. Windsor, B. Cocanougher, D. G. Weilbaecher, Neal Kleiman, F. W. Smart, D. L. Nelson, E. C. Lawrence

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Rejection dynamics after heart transplantation might be characterized by soluble interleukin-2 receptor levels. To determine whether elevated levels early (measured by enzyme-linked immunosorbent assay once weekly the first 3 weeks at time of heart biopsy) after transplantation predict mortality and development of coronary disease, the means of these three determinations and the endomyocardial biopsy scores (McAllister scale 0-10) were compared for survivors and nonsurvivors and patients who had coronary arteriopathy develop and those who did not. Fifty-five patients alive 30 days after heart transplantation were prospectively followed up. Overall, 47 patients were male (85%), and the median age was 51 years. Mean ± SD follow-up was 26 ± 15 months (range, 1 to 54 months). There were 38 survivors (69%), and coronary arteriopathy developed in 15 patients (27%). Whereas mean ± SD heart biopsy scores for the early weeks were similar between survivors and nonsurvivors (3.6 ± 1.4 vs 4.4 ± 1.6; p > 0.05), the difference in soluble interleukin-2 receptor levels was significant(703 ± 362 U/ml vs 1793 ± 1070 U/ml; p <0.001). A mean level <1000 U/ml in any given patient predicted long-term survival with a 76% sensitivity, 79% specificity, and 88% negative predictive value. Mean receptor levels for those patients in whom coronary arteriopathy did not develop were 880 ± 846 U/ml and for those with this difficulty, 1410 ± 590 U/ml (p = 0.001). Late morbidity and mortality after heart transplantation seem predicted by early elevation of plasma soluble interleukin-2 receptor levels. More aggressive immunotherapy after heart transplantation might be warranted to attenuate some aspects of late mortality and morbidity if soluble interleukin-2 levels are noted to be consistently elevated early.

Original languageEnglish (US)
Pages (from-to)243-250
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume10
Issue number2
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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