Lymphocytes cross-matching as retrospective tool for hyper-acute rejection diagnosis in heart transplantation.

Abstract

BackgroundLymphocyte cross-matching (CDC) is considered as important screening test that is unfrequently performed preoperatively in heart transplantation procedures. This test is desired to identify the risk for hyper-acute rejection in immediate postoperative period. Patient and methodThere were 57 patients (51 men and 6 women) in mean age of 44 +/- 14 between 2010 and 2019 screened for CDC tests. All patients were low risk for rejection including negative panel reactive antibody preoperative test. Preoperative donor's blood samples and lymph nodes were obtained during retrieval. Recipients blood samples were collected before surgery. CDC test were obtained retrospectively. Endomyocardial biopsies including immunopathological staining were performed on 6th and 14th postoperative day. ResultsThe results obtained from cross-match test revealed 4 patients with lymphocytic T and B incompatibility (positive for cellular and humoral hyper-acute rejection) and 3 more for Lymphocytes B hyper-acute rejection (humoral rejection). All patients were hemodynamically stable. Successful therapy including high doses of polyvalent immunoglobulins and steroids parenteral infusions were proven by endomyocardial biopsies samples. ConclusionThe lymphocytic cross-match testing is useful as postoperative examination. It help to find high risk patients for hyper-acute rejection. It allows for introduction immediate immunosuppressive therapeutic adjustment.