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Updated: Aug 4, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
The significance of left ventricular volume measurement after heart transplantation using radionuclide techniques
Insights
Technetium 99m scanning of left ventricular volumes can help detect acute heart transplant rejection. Decreased stroke volume strongly correlates with rejection severity, aiding graft monitoring.
Area of Science:
- Cardiology
- Nuclear Medicine
- Transplant Surgery
Background:
- Acute rejection is a major complication after heart transplantation.
- Early detection of rejection is crucial for graft survival.
- Non-invasive monitoring methods are needed to complement endomyocardial biopsies.
Purpose of the Study:
- To evaluate the utility of Technetium 99m labeled red blood cell scanning for assessing acute rejection in heart transplant recipients.
- To correlate left ventricular volume parameters with histological rejection scores.
Main Methods:
- Multigated equilibrium blood pool scanning (MEBPS) using Technetium 99m labeled red blood cells was performed.
- Endomyocardial biopsies were obtained simultaneously and scored for acute rejection.
- Left ventricular volumes (end-diastolic, end-systolic, stroke volume) were measured by MEBPS.
- Data were analyzed using non-parametric statistical methods.
Main Results:
- A significant correlation was found between decreased stroke volume and the severity of acute rejection.
- Decreased end-diastolic left ventricular volumes showed a weaker correlation with rejection.
- Changes in end-systolic left ventricular volumes approached statistical significance when correlated with rejection scores.
Conclusions:
- Technetium 99m MEBPS can be a valuable tool for detecting and monitoring acute rejection in heart transplant patients.
- Changes in stroke volume are a sensitive indicator of acute rejection.
- This non-invasive technique may reduce the need for repeated endomyocardial biopsies.
Abstract:
Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts.
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