From 535 endomyocardial biopsies (87 heart transplant recipients) 283 cell cultures could be generated. All cultures tested contained T lymphocytes and in most cases CD4 was the predominant phenotype at any time posttransplant. A significantly higher proportion of CD8-dominated cultures was found among cultures from biopsies without myocytolysis.

In the first 3 months post transplant 57% of cultures showed cytotoxicity against both class I and class II mismatched donor major histocompatibility complex (MHC) antigens, changing to an incidence of 33% at > 90 days. This proved to be due to a significant decrease in the number of cultures with human leukoctye antigen class II-directed cytotoxicity.

This study shows that early after transplantation a heart transplant is infiltrated with activated donor-specific cytotoxic T cells which recognize a broad spectrum of mismatched donor MHC antigens, and that in time this spectrum becomes more restricted.

dx.doi.org/10.1016/0198-8859(91)90071-G, hdl.handle.net/1765/59670
Human Immunology
Department of Cardiology

Ouwehand, A.J, Vaessen, L.M.B, Baan, C.C, Jutte, N.H.P.M, Balk, A.H.M.M, Essed, C.E, … Weimar, W. (1991). Alloreactive lymphoid infiltrates in human heart transplants: Loss of class II-directed cytotoxicity more than 3 months after transplantation. Human Immunology, 30(1), 50–59. doi:10.1016/0198-8859(91)90071-G