Allografts cardiac

Cardiovascular disease has been identified as one of the leading causes of death in organ transplant recipients.55 Posttransplant hypertension (HTN) is associated with an increase in cardiac morbidity and patient mortality in all transplant patients and is also an independent risk factor for chronic allograft dysfunction and loss.56 Based on all the available posttransplant morbidity and mortality data, it is imperative that posttransplant HTN be identified and managed appropriately. 

Weis M, von Scheidt W. Cardiac allograft vasculopathy a review. Circulation 1997 96 2069-2077. 

Labarrere CA, Nelson DR, Park JW. Pathologic markers of allograft arteriopathy insight into the pathophysiology of cardiac allograft chronic rejection. Curr Opin Cardiol 2001 16 110-117. 

Morita K, Miura M, Paolone DR, et al. Early chemokine cascades in murine cardiac grafts regulate T cell recruitment and progression of acute allograft rejection. J Immunol 2001 167 2979-2984. 

El-Sawy T, Belperio JA, Strieter RM, Remick DG, Fairchild RL. Inhibition of polymorphonuclear leukocyte-mediated graft damage synergizes with short-term costimulatory blockade to prevent cardiac allograft rejection. Circulation 2005 112 320-331. 

Gao W, Topham PS, King JA, et al. Targeting of the chemokine receptor CCR1 suppresses development of acute and chronic cardiac allograft rejection. J Clin Invest 2000 105 35-44. 

Yun JJ, Fischbein MP, Laks H, et al. Rantes production during development of cardiac allograft vasculopathy. Transplantation 2001 71(11) 1649-1656. 

Haskell CA, Hancock WW, Salant DJ, et al. Targeted deletion of CX(3)CR1 reveals a role for fractalkine in cardiac allograft rejection. J Clin Invest 2001 108 679-688. 

Robinson LA, Nataraj C, Thomas DW, et al. A role for fractalkine and its receptor (CX3CR1) in cardiac allograft rejection. J Immunol 2000 165 6067-6072. 

Shimizu, K. et al., Host CD40 ligand deficiency induces long-term allograft survival and donor-specific tolerance in mouse cardiac transplantation but does not prevent graft arteriosclerosis, J. Immunol., 165, 3506, 2000. 

Orosz CG Mechanisms of graft acceptance evidence that plasminogen activator controls donor-reactive delayed-type hypersensitivity responses in cardiac allograft acceptor mice. J Immunol 2000 164 5132-5139. 

Kapp JA, Honjo K, Kapp LM, Xu X, Cozier A, Bucy RP TCR transgenic CD8+ T cells activated in the presence of TGF-fi express FoxP3 and mediate hnked suppression of primary immune responses and cardiac allograft rejection. Int Immunol 2006 18 1549-1562. 

Cardiac/Hepatic allograft rejection Treatment of steroid-resistant acute allograft rejection in cardiac and hepatic transplant patients. 

Cardiac/hepatic allograft rejection, steroid resistant 5 mg/day for 10 to 14 days. Begin treatment when it is determined that a rejection has not been reversed by an adequate course of corticosteroid therapy. 

EstorchM, Camprecios M, Flotats A, Mari C, Berna L, Catafau AM et al. Sympathetic reinnervation of cardiac allografts evaluated by 123I-MIBG imaging. J Nucl Med 1999 40 911-916... 

Eisen HJ, Tuzcu EM, Dorent R, Kobashigawa J, Mancini D, Valantine-von Kaeppler HA et al. Everohmus for the prevention of allograft rejection and vasculopa-thy in cardiac-transplant recipients. N Engl J Med 2003 349(9) 847-58. 

Muromonab-(CD3) Orthoclone OKT3) is a mouse monoclonal antibody that is a purified IgG. It is used for the prevention of acute allograft rejection in kidney and hepatic transplants and as prophylaxis in cardiac transplantation. It is also used to deplete T cells in marrow from donors before bone marrow transplantation. 

B. Indications and use Orthoclone OKT3 is indicated for the treatment of acute allograft rejection in renal transplant patients and for the treatment of steroid-resistant acute allograft rejection in cardiac and hepatic transplant patients. 

Bastian, N. R., Xu, S., Shao, X. L., Shelby, J., Granger, D. L., and Hibbs, J. B., Jr. (1994). N omega-monomethyl-L-arginine inhibits nitric oxide production in murine cardiac allografts but does not affect graft rejection. Biochim. Biojjhys. Acta 1226, 225—231. 

Murase, N., Kim, D. G., Todo, S., Cramer, D. V., Fung, J. J., and Starzl, T. E. (1990). Suppression of allograft rejection with FK506. 1. Prolonged cardiac and liver survival in rats following short-course therapy. Transplantation 50, 186-189. 

Muromonoab-CD3 is used for the treatment of acute organ transplant rejection. It is effective in preventing graft rejection after kidney, heart or liver transplantation. Muromonoab-CD3 is effective in patients who after acute cardiac or liver allograft rejection do not respond to steroid therapy. It is administered intravenously and with a dose of 5 mg/day, a general concentration range of 400-1500 ng/ml can be achieved. A serum concentration of 600-1150 ng/ml in renal transplant patients produces desirable immunosuppressive effects. The levels of CD3 expression, their production and antibodies to the drug determine its rate of clearance. In the absence of antibodies to muromonoab-CD3, its half-life is about 18 h. 

Bishop DK, Shelby J, Eichwald EJ. 1992. Mobilization of T lymphocytes following cardiac transplantation. Evidence that CD4- positive cells are required for cytotoxic T lymphocyte activation, inflammatory endothelial development, graft infiltration and acute allograft rejection. Transplantation. 53 849-857. 

Bishop DK, Li W, Chan SY, Ensley RD, et al. 1994. Helper T lymphocytes unresponsiveness to cardiac allografts following transient depletion of CD4-positive cells. Implications for cellular and humoral responses. Transplantation. 58 576-584. 

Hall B, Jelbart ME, Gurley KE, Dorsch SE. 1990. Specific unresponsiveness in rats with prolonged cardiac allograft survival after treatment with cyclosporine. III. Further characterization of CD4+ suppressor cell and its mechanisms of action. J Exp Med. 171 141-157. 

Zhang Q, Chen Y, Fairchild RL, Heeger PS, et al. 2006. Lymphoid sequestration of alloreactive memory CD4 T cells promotes cardiac allograft survival. J Immunol. 176 770-777. 

Schofield RS, Hill JA, McGinn CJ, Aranda JM. Hormone therapy in men and risk of cardiac allograft rejection. J Heart Lung Transplant 2002 21(4) 493-5. 

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