Cardiac graft and the scintigraphies: the study by thallium 201 and indium 111-antimyosin antibodies

Seventy studies were effected on 17 cardiac grafts studied prospectively during 1 year: a 201Tl tomo-scintigraphy at rest and a scintigraphy by 111In-antimyosin antibodies (SAM) with planar images, taken 48 h after the injection of 2 mCi of Myoscint, with the determination of heart/lung (H/L) fixation index were achieved iteratively 1,2,3,6 and 12 months after transplant. The results of thallium scintigraphies permitted identification of 2 groups of patients: A (n = 8, normal) and B (n = 8, abnormal). The groups A and B were comparable in what concerns the age, the sex of patients, age of donors, time of graft ischemia, the mean C/P index at 1,2,3,6 months. There were more ischemic cardiopathies in the receivers who developed graft anomalies than the others (5 vs 0; p < 0.03) and it existed more male donors in the group B (0/8 vs 5/8, p < 0.03). The results of SAM were confronted to those of endo-myocardial biopsies and showed a diminished C/P in the first 6 months (p = 0.002); in exchange, C/P were not significantly different in presence or in absence of rejects (1.78 vs 1,82) but more cases of rejection justifying a specific treatment were observed when C/P at 1 month was ≥ 2 (12 cases in 86 months of surveillance vs 3 in 72 months). In conclusion, the thallium at rest may show early perfusion anomalies which seem to be more frequent in ischemic patients. The SAMs do not replace the biopsies in the graft follow-up but the precocious fixation index may be worth in the short-term prognostication