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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015
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AFRICA
a light microscope. Sections were also taken from the rejected
transplants of the recipients, stained with haematoxylin and
eosin dye and examined under the light microscope.
Histological findings on the endomyocardial sections were
graded on the basis of the endomyocardial biopsy grading
scheme, which is standardised by the International Society for
Heart and Lung Transplantation (ISHLT). Grading was defined
as follows: no lymphocytic infiltration: grade 0; focal or diffuse
but rare lymphocytic infiltration: grade 1 (Fig. 2); unifocal
aggressive lymphocyte infiltration: grade 2 (Fig. 3); multifocal
aggressive lymphocyte infiltration: grade 3 (Fig. 4); diffuse
aggressive polymorph infiltration: grade 4 (Fig. 5).
Statistical analysis
Data were transferred into the computer. Statistical analyses
were done using the SPSS program (SPSS Inc, Chicago, IL,
USA). Since the number of subjects in the groups was not equal,
they were compared by the Mann–Whitney
U
-test. Level of
statistical significance was considered to be
p
< 0.05.
Results
A total of 19 pairs of New Zealand rabbits were used in this
study. The weight of the study subjects was a minimum of 2 550
g and a maximum of 3 200 g. Duration of motor activity after
transplant was determined to be a minimum of 2.5 hours and
a maximum of four hours in all subjects. Biopsy scoring was
found to be a minimum grade 1 and maximum grade 4. Duration
of motor activity of the transplants and biopsy scoring of the
groups are shown in Table 1.
Discussion
In this study, a total of 19 transplantations were performed, of
which 10 were in the MMF and nine in the MP group. We aimed
to compare MMF, an immunosuppressive agent, with MP, a
steroid. Either MMF or MP was administered to the recipients
for two days prior to the surgery. The immunosuppressive agent
was not given to the subjects on the day of surgery.
The transplant, which was placed retroperitoneally, was
excised after its motor activity had completely stopped. It was
observed that duration of motor activity of the transplant
was statistically significantly longer in the MMF group. No
statistically significant difference was observed between the
MMF and MP groups in terms of transplant rejection.
Fig. 2.
Focal or diffuse but sparse lymphocytic infiltration, grade 1.
Fig. 3.
A focus of aggressive lymphocytic infiltration, grade 2.
Fig. 4.
Multifocal aggressive lymphocytic infiltration, grade 3.
Fig. 5.
Diffuse aggressive polymorph infiltration, grade 4.
Table 1. Duration of motor activity of the transplants, and
biopsy scoring of the groups
Group 1 (MMF)
(recipient)
(
n
=
10)
Group 2 (MP)
(recipient)
(
n
=
9)
p
-value
Motor activating time (h)
3.20
±
0.42
2.77
±
0.26 0.013*
Biopsy scoring
2.80
±
1.23
2.78
±
0.83 0.865*
Biopsy scoring (grade)
2761
±
196.1 2868.3
±
202.2
*
p
-value was presented as a result of Mann–Whitney
U
-test.