The Annals of Thoracic Surgery, Vol 45, 158-163, Copyright © 1988 by The Society of Thoracic Surgeons
Value of urinary polyamines as noninvasive markers of cardiac allograft rejection in the dog
M Carrier, DH Russell, TP Davis, RW Emery and JG Copeland
Department of Cardiovascular and Thoracic Surgery, University of Arizona, Tucson.
A noninvasive marker of cardiac allograft rejection would be useful
clinically. Lymphocyte proliferation and organ rejection may cause changes
in urinary polyamine excretion. To test this hypothesis, cervical
heterotopic heart transplantations were performed in a group of 6
nonimmunosuppressed dogs and in a group of 9 dogs treated with cyclosporine
(N = 3) or cyclosporine and steroids (N = 6). A group (N = 3) having a sham
operation was also studied. Serial biopsies of the transplanted hearts were
performed. Urinary polyamine levels were measured daily by high-pressure
liquid chromatography of urine specimens. Between 2 and 4 days after
transplantation, the transplanted hearts of all animals without
immunosuppression demonstrated histological rejection. An early increase in
putrescine levels and in total urinary polyamine levels was observed in
this group. In the treated groups, histological rejection appeared from the
second to the eighth day after transplantation. Each episode of rejection
occurred from 1 day to 4 days after a significant increase in urinary
polyamine levels compared with the preoperative baseline level (p less than
0.01). In contrast, polyamine excretion in 3 dogs after sham operations
remained unchanged. Thus, urinary excretion of polyamines increases before
the appearance of histological rejection; this suggests that changes in
urinary polyamine levels may be a useful marker of cardiac allograft
rejection.
