ORIGIN OF PLEURAL CELLS AFTER LUNG TRANSPLANTATION - FROM DONOR OR RECIPIENT

We evaluated the change in the percentage of cells of donor origin in pleural fluid of 13 consecutive patients who underwent lung transplant ation. Pleural fluid was sampled 2, 4, and 8 days after lung transplan tation. DNA, which was extracted from the blood of donors and recipien ts and from the pleural fluid, was amplified using a polymerase chain reaction technique. i The reaction products were electrophoresed, and bands indicating amplified human leukocyte antigen (HLA)-DR alleles we re quantified by determining the area under the curve (AUC) by a densi tometric analysis. HLA-DR alleles, which were present only in recipien t cells (recipient I allele), were analyzed and compared to HLA-DR all eles that were present only in donor cells (donor allele). A dilution study was first performed to provide a standard curve relating the per centage of donor and recipient cells in a mixture to their AUC. The AU C of the recipient alleles did not change significantly over the first 8 postoperative days. The AUC of the donor alleles was less on postop erative days 4 and 8 than on day 2 (p<0.05). The donor allele AUC on d ay 8 was <20% of the shared allele AUC, corresponding to <1% of all ce lls by the dilution study. We conclude that donor cells are rapidly cl eared from the pleural space after lung transplantation,with <1% of ce lls of donor origin by postoperative day 8.