EVALUATION OF PLASMA-LEVELS OF TUMOR-NECROSIS-FACTOR-ALPHA AND INTERLEUKIN-6 AS REJECTION MARKERS IN A COHORT OF 142 HEART-GRAFTED PATIENTSFOLLOWED BY ENDOMYOCARDIAL BIOPSY

The rejection reaction after cell or organ transplantation has to be d etected as early as possible in order to conduct optimal immunosuppres sive treatment. among the numerous events leading to rejection, cytoki ne production, especially of tumour necrosis factor alpha, is particul arly important. Interleukin-6 and tumour necrosis factor alpha were in vestigated in 142 heart-grafted patients in order to define an early p eripheral non-invasive marker of an acute rejection that could fit wel l with myocardial biopsy results. Cytokines were immunoenzymatically m easured in blood specimens collected on the day of the endomyocardial biopsy. The values were compared to the grade of heart graft rejection established according to pathological criteria. Plasma interleukin-6 and especially tumour necrosis factor alpha determined on the day of t he rejection diagnosis were significantly increased in the patient sam ple with moderate or severe rejection when compared with mean values o f interleukin-6 and tumour necrosis factor alpha in the patient sample without rejection or with mild rejection (P=0.04 and 0.001 respective ly). Because high levels of tumour necrosis factor alpha may appear be fore histological signs, this biological marker could be useful in the follow-up of heart-grafted patients.