Eosinophil count, allergies, and rejection in pediatric heart transplant recipients

Arbon, Kate S.; Albers, E.; Kemna, Mariska; Law, Sabrina; Law, Yuk M.

doi:10.1016/j.healun.2015.03.014

Cited by 14 publications

(15 citation statements)

References 35 publications

(34 reference statements)

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“…BNP is frequently used as a serum marker of allograft functional status as it is known to be elevated in response to increased ventricular wall stress and/or elevated filling pressures, hallmarks of graft dysfunction and rejection . However, BNP can be influenced by several other biological mechanisms or clinical states, including anemia, volume status, changes in renal function, and infection . GLS is less likely to be falsely elevated in these settings.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Wisotzkey

Jorgensen

Albers

et al. 2017

Pediatric Transplantation

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Evaluation of myocardial mechanics after heart transplant is important in monitoring allograft function and identifying rejection. Speckle tracking global longitudinal strain (GLS) may be more sensitive to early regional changes from rejection. This study aimed to determine feasibility of GLS in pediatric hearts during surveillance echocardiograms, compare their GLS to published norms (-18% to -22%), and assess association of GLS with other indices of graft function. Retrospective review of transplant echocardiograms from 2013 to 2014. Philips QLAB was used for post-acquisition GLS analysis. Multiple linear regression was used to assess the association of GLS with echocardiographic/catheterization indices, and B-type natriuretic peptide (BNP). Forty-seven patients (84 studies) were included. Calculation of GLS was feasible in 82 studies (97%) with inter- and intra-observer variability of 0.71 and 0.69. Patients (n=9) with rejection had GLS of -16.4% (SD=3.5%) compared to those without [-16.8% (SD=3.7%)]. GLS worsened linearly with increasing Ln(BNP) (P=<.001), left ventricular volume in diastole (P=<.001), septal a' wave (P=<.001), and pulmonary capillary wedge pressure (P=<.001). Speckle tracking-based GLS is feasible and reproducible in pediatric heart recipients and is reduced at baseline. The role of GLS and BNP in detecting early systolic dysfunction warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Wisotzkey

Jorgensen

Albers

et al. 2017

Pediatric Transplantation

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“…Although the correlation between eosinophilic infiltration and acute rejection is known in kidney transplantation, we found only one report of such correlation in the field of pancreas transplantation . There are some reports about the relationship between eosinophils and acute rejection in pediatric transplants or liver transplants . According to these articles, peripheral eosinophilia or gastrointestinal infiltration of eosinophil is related with a higher tendency of graft rejection.…”

Section: Discussionmentioning

confidence: 87%

“…15 There are some reports about the relationship between eosinophils and acute rejection in pediatric transplants or liver transplants. [26][27][28][29] According to these articles, peripheral eosinophilia or gastrointestinal infiltration of eosinophil is related with a higher tendency of graft rejection. The authors suggested that the mechanism of rejection is related with eosinophils through the T helper 2 (Th2) cell-dominant immune response.…”

Section: Discussionmentioning

confidence: 99%

Eosinophil‐to‐monocyte ratio is an excellent predictor of acute cellular rejection in pancreas transplant alone recipients

Ryu

Shim

et al. 2020

Clinical Transplantation

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Serum pancreatic enzymes (serum amylase and lipase) are sensitive markers for monitoring acute rejection in pancreatic transplant recipients. However, those enzymes are not specific, as their levels are elevated in other conditions. We evaluated the eosinophil‐to‐monocyte ratio (EMR) in peripheral blood as a biomarker of acute rejection in the clinical setting in recipients of pancreatic transplant alone. We performed 32 cases of pancreatic transplantation alone since 2015. Nine patients were diagnosed with rejection. Serum amylase and lipase levels and eosinophil and monocytes counts were analyzed and compared retrospectively between the non‐rejection and rejection groups. The serum eosinophil count, eosinophil fraction of the complete blood count, and serum amylase and lipase levels were significant predictors of rejection according to the receiver operation characteristic (ROC) curve. However, the EMR was the best indicator of rejection based on the ROC curve (area under the curve 0.918, sensitivity 100%, specificity 76.2% at the cutoff value 0.80, P < .001). The combination of EMR and the lipase level had 100% sensitivity and 90.5% specificity. The EMR is a simple and excellent predictor of acute rejection in recipients of pancreatic transplant alone.

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“…Although not well established in the pathophysiology of rejection, eosinophils are known to degranulate within myocardial tissue, releasing cationic proteins that mediate myocardial tissue damage and local inflammation in eosinophilic myocarditis . However, other authors have failed to demonstrate a relationship between eosinophil count and the risk of rejection, and at least one study has suggested that elevated eosinophil count may be protective …”

Section: Discussionmentioning

confidence: 99%

Sudden death in a pediatric heart transplant recipient with peripheral eosinophilia and eosinophilic myocardial infiltrates

McEachern

Godown

Dodd

et al. 2017

Pediatric Transplantation

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Eosinophilia has been rarely reported in pediatric heart transplant recipients and has been suggested to play a role in graft rejection. We report a case of a young female patient with peripheral blood eosinophilia who died suddenly 2 years following ABO-incompatible heart transplantation. She was found at autopsy to have myocardial infiltration of not only T-lymphocytes and macrophages expected in acute cellular rejection but also of eosinophils, B-lymphocytes, and plasma cells indicating myocarditis.

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Eosinophil count, allergies, and rejection in pediatric heart transplant recipients

Cited by 14 publications

References 35 publications

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Feasibility and interpretation of global longitudinal strain imaging in pediatric heart transplant recipients

Eosinophil‐to‐monocyte ratio is an excellent predictor of acute cellular rejection in pancreas transplant alone recipients

Sudden death in a pediatric heart transplant recipient with peripheral eosinophilia and eosinophilic myocardial infiltrates

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