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J Thorac Cardiovasc Surg 1996;112:1315-1318
© 1996 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

INDUCTION OF TOLERANCE TO AN EXPERIMENTAL CARDIAC ALLOGRAFT THROUGH INTRATHYMIC INOCULATION OF CLASS II MAJOR HISTOCOMPATIBILITY COMPLEX DISPARATE ANTIGENS

Zhenya Shen, MD, Muhammad Mohiuddin, MD, Hitoshi Yokoyama, MD, PhD, G. Russell Reiss, MD, Verdi J. DiSesa, MD

From the Department of Cardiothoracic Surgery, The Medical College of Pennsylvania and Hahnemann University School of Medicine, Philadelphia, Pa.

Received for publication March 25, 1996; revisions requested May 8, 1996; revisions received May 17, 1996 Accepted for publication May 21, 1996. Address for reprints: Verdi J. DiSesa, M.D., Cardiothoracic Surgery, Medical College of Pennsylvania Hospital, 3300 Henry Avenue, Philadelphia, PA 19129.

Abstract

Indefinite donor-specific tolerance to a cardiac allograft can be induced through pretransplantation intrathymic injection of donor spleen cells and a single intraperitoneal injection of antilymphocyte serum. This study was designed to determine whether this phenomenon was reproducible with grafts differing in either class I major histocompatibility complex only or class II MHC only. Donors of cells and hearts in all experiments were RP rats. Class I MHC disparate grafts were performed by placing an RP heart into a Lewis recipient, and class II disparate grafts were performed with RP donors and Wistar Furth recipients. Lewis (n = 10) and Wistar Furth (n = 10) recipients underwent intraperitoneal injection of 1 ml antilympocyte serum and intrathymic injection of 5 x 107 RP spleen cells. Three weeks later, heterotopic cardiac transplantation was done with a heart from an RP rat. Control rats had no pretreatment or received antilympocyte serum alone. Without pretreatment, RP hearts survived 7 to 9 days (mean 8 days) in Lewis recipients (n = 5) and 9 to 14 days (mean 12 days) in Wistar Furth recipients (n = 5). Antilymphocyte serum alone produced slight prolongation of graft survival. Lewis rats pretreated with class I disparate RP splenocytes and antilympocyte serum had graft survivals of 8 to 27 days (mean 14 days), not significantly different from the results with antilympocyte serum alone. Class II disparate RP grafts placed in pretreated Wistar Furth rats had significant prolongation of graft survival, with four of five grafts surviving longer than 60 days (p < 0.01 vs antilympocyte serum alone). These results suggest that a disparity at the class II locus of the major histocompatibility complex is critical for the induction of cardiac allograft tolerance after intrathymic inoculation of allogeneic cells. (J THORACCARDIOVASCSURG1996;112:1315-8)






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