  
Lymphoid irradiation may reduce heart transplant-related atherosclerosis
Last Updated: 2001-04-30 9:59:48 EDT (Reuters Health)
By Joene Hendry
WESTPORT, CT (Reuters Health) - In a group of cardiac transplant patients, those treated with total lymphoid irradiation for repeat rejection episodes appear to develop less coronary atherosclerosis than those not treated, according to data presented Thursday at the International Society for Heart and Lung Transplantation meeting in Vancouver, Canada.
Dr. Marc P. Pelletier and colleagues at Stanford University in California conducted a retrospective analysis of post-transplant angiograms in a group of 31 cardiac transplant patients who required total lymphoid irradiation for persistent or recurrent allograft rejection. They compared these angiograms with those from a group of 32 cardiac transplant patients not treated with total lymphoid irradiation.
The patients were matched for donor and recipient gender, age, race, and CMV status at the time of transplant as well as induction and immunosuppressive therapy. The researchers report the study group had mean of 4.4 rejection episodes compared with 2.3 episodes for controls. Mean followup was 5.7 years for the study group and 6.9 years in controls.
"Despite more rejection episodes and despite a greater proportion of ischemic heart disease...only 8 of 31 patients in our study group developed any evidence of atherosclerosis on angiography testing, versus 19 of 32 in our control group," Dr. Pelletier told Reuters Health.
He said that, while the findings are interesting, "a randomized trial would be needed to provide conclusive results, but this patient population is very difficult to randomize."
Used mostly during the 1990s, total lymphoid irradiation has become less common with the development of new immunosuppressive drugs during the last few years, Dr. Pelletier noted. He added, however, that total lymphoid irradiation "is still a very nice therapy for patients undergoing repeat rejections."
-Westport Newsroom 203 319 2700
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