[Diagnosis of rejection using immunologic probe in lung allotransplantation]

We attempted to establish the method of early diagnosis of rejection in lung transplantation using dog, rat and monkey experimental models. Orthotopic left lung allotransplantation was performed in these animals and lymphocytes from peripheral blood (PBL) and/or bronchoalveolar lavage fluid (BALF) were examined as a probe of rejection monitoring. The recipient dog showed a decreased response of PBL to PHA and an increased spontaneous blastogenesis (SB) at the period undergoing rejection which were confirmed by blood samples taken within 2 days before sacrifice of the animal. In rat lung transplantation, 2 groups of animal pair were used; WKA to F344, and WKY to F344. The former recipient rejected the graft within 5 days postoperatively and the latter rejected within 2 weeks after the operation. In both groups parameters for detection of rejection included lymphocyte count, SB and T cell subsets of PBL and BALF lymphocyte. Lymphocyte SB of BALF from lung transplant reflected early stage of rejection and preceded the changes in PBL. This seemed to be useful for early diagnosis of lung allograft rejection. In monkey experiment, BALF lymphocyte from the transplanted lung seemed to well reflect the grade of rejection when compared total cell count and differential cell count with histologic findings of the graft, though the number of this experiment was small.