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Intragraft interleukin 2 mRNA expression during acute cellular rejection and left ventricular total wall thickness after heart transplantation
  1. H A de Groot-Kruseman1,*,
  2. C C Baan1,
  3. E M Hagman4,
  4. W M Mol1,
  5. H G Niesters2,
  6. A P Maat3,
  7. P E Zondervan5,
  8. W Weimar1,
  9. A H Balk4
  1. 1Department of Internal Medicine, University Hospital Rotterdam, Rotterdam, Netherlands
  2. 2Diagnostic Institute of Molecular Biology, University Hospital Rotterdam, Rotterdam, Netherlands
  3. 3Department of Thoracic Surgery, University Hospital Rotterdam, Rotterdam, Netherlands
  4. 4Department of Cardiology, University Hospital Rotterdam, Rotterdam, Netherlands
  5. 5Department of Pathology, University Hospital Rotterdam, Rotterdam, Netherlands
  1. Correspondence to:
    Dr H A de Groot-Kruseman, University Hospital Rotterdam, Department of Internal Medicine, Room Bd 299, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands;


Objective: To assess whether diastolic graft function is influenced by intragraft interleukin 2 (IL-2) messenger RNA (mRNA) expression in rejecting cardiac allografts.

Design: 16 recipients of cardiac allografts were monitored during the first three months after transplantation. The presence of IL-2 mRNA in endomyocardial biopsies (n = 123) was measured by reverse transcriptase polymerase chain reaction. To determine heart function, concurrent M mode and two dimensional Doppler echocardiograms were analysed.

Results: Histological signs of acute rejection (International Society for Heart and Lung Transplantation (ISHLT) rejection grade > 2) were strongly associated with IL-2 mRNA expression (IL-2 mRNA was present in 12 of 20 endomyocardial biopsies (60%) with acute rejection and in 24 of 103 endomyocardial biopsies (23%) without acute rejection, p = 0.002). No significant relation was found between either histology or IL-2 mRNA expression alone and the studied echocardiographic parameters. However, stratification of the echocardiographic data into those of patients with and those without acute rejection showed that during acute rejection IL-2 mRNA expression was significantly associated with increased left ventricular total wall thickness (mean change in total wall thickness was +0.22 cm in patients with IL-2 mRNA expression versus −0.18 cm in patients without IL-2 mRNA expression, p = 0.048).

Conclusions: An increase in left ventricular total wall thickness precedes IL-2 positive acute rejection after heart transplantation. Thus, cardiac allograft rejection accompanied by intragraft IL-2 mRNA expression may be indicative of more severe rejection episodes.

  • transplantation
  • echocardiography
  • acute rejection
  • interleukin-2
  • AR+, in the presence of acute rejection
  • AR−, in the absence of acute rejection
  • cDNA, complementary DNA
  • E, peak early mitral flow velocity
  • EMB, endomyocardial biopsy
  • IL, interleukin
  • ISHLT, International Society for Heart and Lung Transplantation
  • mRNA, messenger RNA
  • PCR, polymerase chain reaction

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  • * Also the Department of Cardiology