J Korean Soc Transplant.  2001 Dec;15(2):125-129.

The Effect of Intravenous Immunoglobulin on Hyperacute and Acclerated Rejection in Heart Transplantation of the Rat

• Kim SC
• Han DJ
• Kim TH
• We YM
• Cho KM

Abstract

Hyperacute or acute accelerated rejection caused by preformed antibody in sensitized patients resulted in increased waiting period and complicated posttransplant hospital course. Intravenous immunoglobulin (IVIG) has known to have anti cytotoxic effect by blocking the anti HLA antibody. PURPOSE: We investigated the effect of IVIG on hyperacute and acclerated rejection of the heart graft in the presensitized rat.
METHODS
Recipients (Wistar) were sensitized from repeated allo (Lewis) skin graft and followed by heterotopic allo cardiac transplantation. A guinea pig was used for the xenotransplantation model. IVIG (Green Cross kappa, 400 mg/kg in allotransplantation, 800 mg/kg in xenotransplantation) was given just before heart transplantation. Graft survival and donor specific IgG, IgM and complement were measured.
RESULTS
Graft survival was 7.2 days in non sensitized allogenic heart transplantation (n=9), 1.3 days in sensitized allogenic recipients (n=7). Graft survival was prolonged from 1.3 days to 4.4 days with IVIG treatment (n=5). As for xenogenic transplantation, graft survival was prolonged from 30 min to 7.4 hr with IVIG treatment (n=5). Donor specific IgG and IgM and complement increment were blocked by IVIG during the IVIG treatment. Donor specific IgG and Ig M and complement were increased after the cessation of IVIG treatment.
CONCLUSION
IVIG was able to prolong the graft survival of the sensitized allograft and xenograft. Suppression of the donor specific IgG, IgM and complement might be one of the underlying mechanisms. A further studies have to follow to clarify the more detailed mechanism.

Keyword

IVIG; Sensitization; Hyperacute rejection

MeSH Terms

Allografts
Animals
Complement System Proteins
Graft Survival
Guinea Pigs
Heart Transplantation*
Heart*
Heterografts
Humans
Immunoglobulin G
Immunoglobulin M
Immunoglobulins*
Immunoglobulins, Intravenous
Rats*
Skin
Tissue Donors
Transplantation, Heterologous
Transplants
Complement System Proteins
Immunoglobulin G
Immunoglobulin M
Immunoglobulins
Immunoglobulins, Intravenous