PubMed · 8055215
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B J Sweetman. 1994. Even garlic.. https://doi.org/10.1093/rheumatology%2F33.8.790-b
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BACKGROUND: Spontaneous tolerance to the orthotopic liver allograft uniformly occurs in the DA (RT1a) to PVG (RT1c) rat combination despite a fully allogeneic barrier. METHODS: To assess whether spontaneous acceptance might be the consequence of a T cell help deficit at the time of the first exposure of alloantigens to the host, we studied the effect of exogenous interleukin (IL)-2 injections at the time of liver transplantation and during long-term follow-up. RESULTS: Although spontaneous acceptance of the liver allograft constantly ensued in the DA to PVG combination, a daily injection of recombinant IL-2 (3 x 10(5) U) uniformly provoked acute cellular rejection of the liver allograft and consequently the death of animals by postoperative day 5-6. Simultaneous to the graft loss, hepatic enzymes (alanine aminotransferase) increased more than 50-fold in IL-2-treated recipients, whereas similar IL-2 treatment did not produce any hepatic dysfunction in syngeneic animals. By immunohistology, the expression of the alpha chain of the IL-2 receptor, usually undetectable in untreated animals, was evident on CD4 and CD8 lymphocytes infiltrating the liver graft. In contrast, a similar IL-2 regimen and even higher IL-2 doses (x 10(6) U) did not abrogate the liver allograft survival during long-term follow-up. CONCLUSIONS: Our results demonstrate that spontaneous rat liver allograft acceptance may be abolished by exogenous IL-2 injections, which suggests that an "inherent T cell help deficit" might be implicated in the spontaneous acceptance mechanisms of DA to PVG liver allografts.
A 1.5-year-old domestic shorthair cat was examined because of vomiting and icterus. Clinicopathologic abnormalities included high alanine transaminase, alkaline phosphatase, and gamma-glutamyltransferase activities and high total bilirubin concentration. During abdominal ultrasonography, the left limb and body of the pancreas appeared hypoechoic, and a small quantity of peritoneal effusion was seen. The liver was diffusely hyperechoic, with echogenicity similar to that of the spleen, indicating hepatic lipidosis. Feline trypsin-like immunoreactivity was high, suggesting that the cat also had pancreatitis. The cat was treated with crystalloid fluids and was fed a protein-restricted diet via a percutaneous endoscopically placed gastrostomy tube. The cat's condition continued to deteriorate despite medical treatment, and it was euthanatized. Necropsy confirmed the clinical suspicion of acute pancreatitis and hepatic lipidosis. This case suggests that measurement of trypsin-like immunoreactivity may be useful in cats suspected of having pancreatitis.
BACKGROUND: The use of kidneys from non-heartbeating donors (NHB) remains controversial. An increased incidence of delayed primary function and primary nonfunction is common. We report a characteristic syndrome of transaminitis and thrombocytopenia after NHB renal transplantation, which may be predictive of graft outcome. METHODS: Two case histories are presented, followed by a retrospective analysis of 38 NHB renal grafts performed at Guy's Hospital from 1988 to 1994. Changes in alanine aminotransferase (ALT) and platelet count were compared between recipients of kidneys from NHB and heartbeating donors (HB). To control for possible effects of antilymphocyte globulin (ALG), two matched control groups receiving HB kidneys with (n=32) and without (n=32) ALG were also compared. RESULTS: ALT was elevated in 32 of 38 (84%) of NHB recipients and 19 of 64 (30%) controls (P<0.001). Mean peak ALT was 172+/-20 U/L in NHB and 42+/-6 U/L in HB kidneys (P<0.001). Use of ALG did not influence mean peak ALT. Elevated ALT predicted impaired graft function (P<0.02) and was associated with an increased length of delayed primary function (P<0.001) and risk of transplant nephrectomy (P<0.05). Thrombocytopenia (<100 x 10(9) cells/L) occurred in 18 of 38 (47%) NHB recipients and in 20 of 64 (31%) controls (P<0.05). Mean nadir platelet count (x 10(9) cells/L) was 113+/-10 in NHB, 128+/-9 in HB with ALG, and 164+/-9 in HB without ALG (both P<0.05 vs. NHB). Patients who underwent graft nephrectomy (n=9) had a disproportionate fall in platelet count (mean nadir, 80+/-11 x 10(9) cells/L; P<0.05). CONCLUSIONS: Transaminitis and thrombocytopenia occur commonly after NHB kidney transplantation and are predictive of graft outcome. Recognition of these changes may assist the early management of NHB renal recipients, and also reduce investigation of "anomalous" results in this setting.