Serum vascular endothelial growth factor as a surveillance marker for cellular rejection in pediatric cardiac transplantation

Transplantation. 2002 Jan 15;73(1):153-6. doi: 10.1097/00007890-200201150-00030.


Background: Early detection and treatment of acute rejection in cardiac transplant recipients significantly improves long-term survival. Endomyocardial biopsy is used routinely for diagnosing allograft rejection; however, in young children, this procedure carries some risk. We evaluated serum vascular endothelial growth factor (VEGF) as a potential surveillance marker of acute cellular rejection.

Methods: Blood samples (n=62) were analyzed from 23 patients and compared with controls (n=18) using an ELISA for VEGF. Results were correlated with endomyocardial biopsy rejection grades.

Results: Mean baseline VEGF levels of the transplant population were consistently higher than controls. Serum VEGF levels were significantly higher during acute cellular rejection when compared with the non-rejecting transplant group (700.7+/-154 pg/ml vs. 190.5+/-29 pg/ml). VEGF decreased two- to eightfold after immunosuppressive therapy in 9 of 11 rejection episodes.

Conclusions: These data suggest that VEGF may play a role in the pathogenesis of acute allograft rejection and it may serve as a reliable serologic surveillance marker.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Biomarkers / blood*
  • Biopsy
  • Child
  • Child, Preschool
  • Endothelial Growth Factors / blood*
  • Graft Rejection / blood
  • Graft Rejection / diagnosis*
  • Graft Rejection / pathology
  • Heart Transplantation / immunology*
  • Heart Transplantation / pathology
  • Humans
  • Infant
  • Lymphokines / blood*
  • Reference Values
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors


  • Biomarkers
  • Endothelial Growth Factors
  • Lymphokines
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors