What question did this study set out to answer?

Determine whether serial monitoring of circulating inflammatory cytokines can reliably predict allograft rejection and therapeutic responsiveness in cardiac transplant recipients.

March 1, 1996Transplantation

The Paradox of Cytokine Monitoring-Predictor of Immunologic Activity as Well as Immunologic Silence Following Cardiac Transplantation

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Why the study?

Does cytokine monitoring predict significant rejection and therapeutic efficacy in patients following heart transplantation?

Population

34 patients following heart transplantation

Comparison

Serial blood levels of 5 cytokines vs null

Design

Cohort

Authors

PKPamela KimballBrown University BCBrano Radovanc v cWeatherford College TITrissy IsomHouston Methodist

Discussion

Member takes

Implication

May support cytokine monitoring to detect rejection after heart transplant; hypothesis-generating and requires prospective validation before practice change.

Key Points

Determine whether serial monitoring of circulating inflammatory cytokines can reliably predict allograft rejection and therapeutic responsiveness in cardiac transplant recipients.
Monitored serial blood levels of five inflammatory cytokines (IL-1, IL-2, IL-6, IL-8, and TNF) in 34 heart transplant recipients.
Correlated cytokine dynamics with clinical rejection outcomes and histologic scores obtained from surveillance endomyocardial biopsies.
IL-6 at ≥15 pg/ml and IL-8 at ≥1000 pg/ml predicted significant rejection 2–4 days before biopsy diagnosis, with sensitivities of 75% and 66% and specificities of 86% and 76%, respectively.
IL-6 levels <15 pg/ml and IL-8 levels <400 pg/ml indicated a rejection-free course, each demonstrating 91% sensitivity with specificities of 81% and 68%, respectively.
Within 48 hours of treatment, IL-6 was 197 ± 20 pg/ml in steroid-resistant patients versus 20 ± 5 pg/ml in responders, while IL-8 rose to 3496 ± 500 pg/ml in OKT3 nonresponders versus 152 ± 50 pg/ml in responders.

Structured PICO

Does cytokine monitoring predict significant rejection and therapeutic efficacy in patients following heart transplantation?

Population

34 patients following heart transplantation

Intervention

Serial blood levels of 5 cytokines (IL-1, IL-2, IL-6, IL-8, and TNF)

Comparator

null

Outcome

Prediction of significant rejection correlated with clinical outcome and endomyocardial biopsy scoressurrogate

Serial monitoring of IL-6 and IL-8 levels can effectively predict the onset of significant rejection and identify resistance to antirejection therapy following heart transplantation.

Cite This Study

Kimball et al. (1996) studied this question.

synapsesocial.com/papers/6a110a73e2199439c8f3307b https://doi.org/10.1097/00007890-199603270-00012

Topics

Heart transplantation

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Implication

May support cytokine monitoring to detect rejection after heart transplant; hypothesis-generating and requires prospective validation before practice change.

The Paradox of Cytokine Monitoring-Predictor of Immunologic Activity as Well as Immunologic Silence Following Cardiac Transplantation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The Paradox of Cytokine Monitoring-Predictor of Immunologic Activity as Well as Immunologic Silence Following Cardiac Transplantation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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