A SERVICE
OF 
Journal
Briefs
January 15, 2001· by TNN Medical Reporter Virginia
Baskerville
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Journal articles published recently have dealt with exercise
capacity following heart transplantation, immune tolerance in miniature swine,
and a role of endothelial cells in graft acceptance and rejection.
- Reduction of the ability of the lung to diffuse carbon monoxide
in heart transplant recipients is associated with abnormal ventilatory and
pulmonary gas exchange responses to exercise and seems to contribute to
exercise limitation in heart transplant recipients, Omar A. Al-Rawas, PhD, and
colleagues at the Glasgow Royal Infirmary in Scotland reported in December in
Chest (2000;118:1661-1670). The authors reached their conclusions
after comparing 26 healthy volunteers with 26 heart transplant recipients
before and after transplantation.
- Kai-C. Sonntag of Massachusetts General Hospital and Harvard
Medical School and colleagues reported in January in The Journal of
Clinical Investigation that their work in miniature swine has
demonstrated the potential to permit immune tolerance to solid organ allografts
when MHC class II matching is accomplished between donors and recipients
through gene transfer (2001;107:65-71). If such a strategy works in humans,
"the benefit would likely be so great that the impetus for living donation
would be even stronger for patients with endstage kidney, liver, lung, and
pancreatic disease," said an editorial by Bruce R. Rosengard and Laurence A.
Turka, both of the University of Pennsylvania (2001;107:33-34).
- Endothelial cells of a transplanted organ are believed to remain
of donor origin after transplantation. However, Emma L. Lagaaij, MD, of Leiden
University Medical Center in the Netherlands and coworkers reported in
The Lancet on January 6 that their research in kidney recipients
suggests that endothelial cells of the recipient can replace those of the donor
in situations involving graft rejection (2001;357:33-37). "We postulate that
endothelium that is damaged by vascular rejection is repaired by endothelial
cells of the recipient," they wrote. "Potentially, endothelial replacement may
have profound implications; it may help us to understand the interactions
between recipient and donor tissues and thus the mechanisms of graft rejection
and acceptance." A commentary by Jordan S. Pober of Yale University School of
Medicine accompanies the article (2001;357:2-3).
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