Tumor necrosis factor-alpha gene polymorphism and death due to acute cellular rejection in a subgroup of heart transplant recipients

Irreversible acute rejection of the transplanted heart usually has a fatal out come. Predicting which recipients are most: likely to reject might allo w closer monitoring and modification of treatment protocols co prevent graf t loss. Recipients generically predisposed to produce more TNF-alpha are th ose who suffer the most acute rejection episodes. Here we show that TNF-alp ha genotype is strongly associated with death due to acute cell-mediated he art transplant rejection (Chi-square = 28.57, P < 0.0001). This subgroup of recipients should be given optimally tissue marched transplants and should be treated with the most effective immunosuppressive regimens. (C) America n Society for Histocompatibility and Immunogenetics, 2001. Published by Els evier Science Inc.