Chimerism of the Transplanted Heart

• Published in: The New England journal of medicine Vol. 346; no. 1; pp. 5 - 15
• Main Authors: Quaini, Federico, Urbanek, Konrad, Beltrami, Antonio P, Beltrami, Carlo A, Finato, Nicoletta, Nadal-Ginard, Bernardo, Kajstura, Jan, Leri, Annarosa, Anversa, Piero
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 03.01.2002
• Subjects: Adult; Aged; Antibodies - analysis; Antigens, Ly - analysis; Antigens, Ly - immunology; ATP-Binding Cassette, Sub-Family B, Member 1 - analysis; ATP-Binding Cassette, Sub-Family B, Member 1 - immunology; Biological and medical sciences; Cardiology. Vascular system; Case-Control Studies; Cell adhesion & migration; Cell Division; Combined surgery. Multiple transplantations; Female; Heart; Heart - physiology; Heart Transplantation; Humans; Male; Medical research; Medical sciences; Membrane Proteins - analysis; Membrane Proteins - immunology; Middle Aged; Myocarditis. Cardiomyopathies; Myocardium - cytology; Proto-Oncogene Proteins c-kit - analysis; Proto-Oncogene Proteins c-kit - immunology; Stem Cells - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Donors; Transplantation Chimera; Transplants & implants; Y Chromosome; Heart; Human; Cardiomyopathy; Sex; Cardiovascular disease; Male; Transplantation; Y-Chromosome; Homotransplantation; Myocardial disease; Signal transduction; Transcription factor GATA4; Treatment; Donor; Heart disease; Surgery; Fluorescence in situ hybridization; Chimerism; Molecular biology
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa012081

Eight male patients received cardiac transplants from female donors. In samples from these hearts, the investigators were able to detect Y chromosomes in about 10 percent of the myocytes, proving that they came from the male recipients. These results show that cells from the recipient are able to migrate into the donor heart and take up residence. Some of the Y-chromosome–positive cells were primitive and had the capacity to proliferate. This study raises the possibility that primitive cells from the recipient may migrate to the donor heart and participate in the remodeling process. The interaction between donor and recipient cells after transplantation has received great attention in an attempt to identify the basis of rejection and graft-versus-host disease. 1 – 3 Cell migration from the allograft to the recipient results in systemic chimerism, 1 , 4 and cell migration from the host to the transplanted organ results in chimerism in the organ. 2 , 5 Chimerism may be detected easily after sex-mismatched organ transplantation with the use of fluorescence in situ hybridization for the Y chromosome. 6 – 8 Systemic chimerism may be recognized when a female host receives an organ from a male donor, and chimerism may be identified in . . .