Role of Platelets and Lymphocytes for the Hemodynamic Effects of Rapidly Injected Antilymphocyte Globulin

Abstract

Xenogenic antilymphocyte globulin (ALG) given as a rapid intravenous injection into dogs caused a significant decrease in arterial blood pressure and oxygenation as well as an increase in portal pressure. At the same time, there was an almost complete elimination of lymphocytes and an extensive but almost completely reversible thrombocytopenia. Lymphocytopenia induced by a previous injection of ALG was found to eliminate completely the circulatory response to a second injection of ALG in spite of the fact that an extensive thrombocytopenia was induced. Extensive thrombocytopenia induced by injection of an antiplatelet globulin was also found to prevent completely the hemodynamic effects of ALG although as many lymphocytes were eliminated as in the intact dogs. Thus both platelets and lymphocytes are necessary to trigger the circulatory response induced by ALG.

Rabbit antithymocyte globulin as induction immunotherapy in pediatric heart transplantation

“…A decrease in platelet count occurs commonly during Thymoglobulin infusion, but the mechanism of Thymoglobulin-induced thrombocytopenia is not clearly understood, although it may involve antiplatelet (2)(3)(4)(5)(6)(7)(8). However, thrombocytopenia is also a frequent consequence of end-stage chronic heart failure in patients waiting for a donor and can also occur as a result of the extracorporeal circulation of blood during heart-transplant surgery.…”

“…Since the first series of right lobe living-donor liver transplantations were reported in 1997 (1), numerous transplant centers have initiated programs to offer this option to adults with liver failure (2)(3)(4), but the issue of hepatic venous reconstruction remains controversial. It is now recognized that the venous drainage of the anterior sector of a right lobe graft may depend largely on branches of the middle hepatic vein (5,6), and failure to reestablish venous drainage through these branches may result in congestion, dysfunction, and even failure of a liver graft (5).…”