PROLATTINA E RIGETTO NEL TRAPIANTO CARDIACO

Many biochemical markers such as beta2-microglobulin, C-reactive protein, neopterin and interferon gamma have been proposed as aid to the diagnosis of rejection episodes in concentrantions of all these markers in the serum dependent on other immunological events, expecially infection. Recently prolactin (hPRL) has been proposed as a new maker of rejection in patients undergoing kidney or heart transplantation. This maker seems a particularly useful predictor because its concentration increases 2 to 8 days before rejection episodes, but the results are still controversial. At the Department of Cardiothoracic Surgery of the University of Pavia, 85 patients underwent a study, correlating the results of serum dosage of hPRL and the score of the corresponding endomyocardial biopsy. The results show a sensibility and specificity of 37% and 57% respectively, giving a test efficiency as low as 51%. In conclusion this study demonstrates the unreliability of the method in the diagnosis of rejection. A monitoring of the immunological activity by periodical hPRL dosage appears not feasible as long as the relationship between hPRL and immunologic system will be clarified.