Sequential interleukin 2 and interleukin 2 receptor levels distinguish rejection from cyclosporine toxicity in liver allograft recipients
M. A. Simpson, T. M. Young-Fadok, P. N. Madras, R. B. Freeman, R. A. Dempsey, D. Shaffer, D. Lewis, R. L. Jenkins and A. P. Monaco
Division of Organ Transplantation, New England Deaconess Hospital, Boston, Mass.
Previous studies of renal transplant recipients have demonstrated that
allograft rejection is accompanied by an increase in plasma and urinary
levels of interleukin 2 and its soluble receptor before the development of
clinical symptoms. After measuring interleukin 2 and interleukin 2 receptor
levels in the plasma, bile, and urine of liver transplant recipients, we
found that rejection is preceded by elevation of plasma and biliary levels
of both substances, that cyclosporine toxicity did not affect either of
these levels, and that urinary levels of the substances are unaffected in
either condition. Levels of interleukin 2 and interleukin 2 receptors
increased in bile earlier than in plasma, and interleukin 2 levels did not
overlap among stable patients and those experiencing rejection, whereas
levels of interleukin 2 receptors did. Serial measurements of interleukin 2
levels, particularly in the product of the transplanted organ, provide a
reliable assessment of the immunologic status of the allograft.
