Abstract
Cardiac transplantation entails surgical disruption of the sympathetic nerve fibres from their somata, resulting in sympathetic denervation. In order to investigate the occurrence of sympathetic re-dnnervation, neurotransmitter scintigraphy using the norepinephrine analogue iodine-123 metaiodobenzylguanidine (MIBG) was performed in 15 patients 2–69 months after transplantation. In addition, norepinephrine content and immunohistochemical reactions of antibodies to Schwarm cell-associated S100 protein, to neuron-specific enolase (NSE) and to norepinephrine were examined in 34 endomyocardial biopsies of 29 patients 1–88 months after transplantation. Anterobasal123I-MIBG uptake indicating partial sympathetic re-dnnervation could be shown in 40% of the scintigraphically investigated patients 37–69 months after transplantation. In immunohistochemical studies 83% of the patients investigated 1–72 months after transplantation showed nerve fibres in their biopsies but not positive reaction to norepinephrine. Significant norepinephrine content indicating re-dnnervation could not be detected in any biopsy. It was concluded that in spite of the lack of norepinephrine content there seemed to be immunohistological and scintigraphic evidence of sympathetic re-dnnervation. An explanation for this contradictory finding may be the reduced or missing norepinephrine storage ability compared to the restored uptake ability of regenerated sympathetic nerve fibres.
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Guertner, C., Krause, B.J., Klepzig, H. et al. Sympathetic re-innervation after heart transplantation: dual-isotope neurotransmitter scintigraphy, norepinephrine content and histological examination. Eur J Nucl Med 22, 443–452 (1995). https://doi.org/10.1007/BF00839059
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DOI: https://doi.org/10.1007/BF00839059