Urinary polyamine levels are markers of altered T lymphocyte proliferation/loss and rejection in heart transplant patients

The studies of urinary polyamine excretion in heart transplant patients reported in this article indicate that total urinary polyamine excretion is increased one to three days before a biopsy-proved rejection in conventionally treated patients, the acetylputrescine to N¹-acetylspermidine ratio becomes elevated before rejection in cyclosporine-treated patients, and the response to elevated ATG therapy during rejection can be evaluated by monitoring urinary polyamine concentrations. We conclude that daily monitoring of urinary polyamine levels may provide a noninvasive biochemical marker that precedes rejection and which parallels the extent of T lymphocyte suppression during the course of immunosuppressive drug therapy.