Immunofluorescent Localization of Human Immunoglobulin in Tissues from Cardiac Allograft Recipients

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Abstract
Direct immunofluorescence studies of 14 human cardiac allografts revealed extensive deposits of immunoglobulin in the sarcolemma, muscle fibers, and in successive layers within the thickened intima of the coronary arteries. In contrast, original hearts from eight recipients and biopsies of six donor hearts taken before transplantation showed little bound immunoglobulin. Sarcolemma-bound IgG was seen significantly more frequently in hearts which succumbed to early rejection. Sera collected before transplantation from 15 to 17 cardiac allograft recipients contained antibodies reactive with cardiac muscle from unrelated donors by indirect immunofluorescence, but not with kidney tissue or skeletal muscle from the same unrelated donors. Pretransplant sera from eight of nine patients also contained antibodies which reacted with the patient's own heart. These results suggest that human cardiac allografts provoke a strong humoral as well as a cell-mediated rejection response and provide evidence which links deposition of immunoglobulin within the arterial intima to the evolution of the obliterative vascular lesion seen in the majority of the cardiac allografts.

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