Monitoring of immunological parameters before and after heart transplantation.

At the immunological examinations carried out prior to heart transplantation, it is crucial to check the compatibility in the ABO blood group system (regardless of the Rh factor) and to perform the cross match (which must be negative). In time pressure, cross match can be omitted provided the patient does not possess cytotoxic antibodies against a representative panel of lymphocytes. Other immunological tests before transplantation are of an auxiliary nature and should provide information whether the patient is a low or high responder, whether he does not suffer from an autoimmune disease or latent viral infection. In 37 out of 44 potential cardiac graft recipients, a strongly suppressed cell-mediated immune response was observed already in the pre-transplantation period. In the post-transplantation period, patients treated with corticoids and Cyclosporin A display a marked prolonged decrease in the absolute values of T4 positive lymphocytes. The absolute values of T3 and T4 lymphocytes represent a reliable parameter to assess the degree of achieved immunosuppression. Long-term monitoring did not reveal a significant association between the values of the T4/T8 index and the rejection episodes.