Abstract
“Multiple MLC's” (parallel tests in recipient, donor and globulin-poor plasma) were performed in 211 consecutive transplant donor-recipient pairs2 The two-way MLC's were performed on patients' lymphocytes before immunosuppression. All grafts regarded as “successful” were at risk for at least six months. Patients with a low MLC (Stimulation Index less than 8 times controls) usually had successful grafts (graft survival was 83% in related transplants and 76% in cadaver transplants). Patients with high MLC's had poor graft survival (0% graft survival in related transplants and 32% in cadaver transplants). An adjusted graft survival was calculated to exclude patients who died with normal renal function (serum creatinine less than 2 mg%). The adjusted graft survival was 91% for living related transplants and 88% for cadaver transplants. Falsely low MLC's occurred when the recipient's plasma contained low-titer cytotoxic antibodies. In 15 recipients of cadaver kidneys, the MLC in recipient plasma was significantly lower than MLC's in donor or globulin-poor plasma. Since the MLC when using cadaver donors was necessarily retrospective, the results were not known pre-transplant and all 15 grafts were rejected. In living related pairs, however, we were able to screen for such antibody activity and could avoid humoral presensitization and cellular compatibility.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Amos D. B., Bach F. H. Phenotypic expressions of the major histocompatibility locus in man (HL-A): leukocyte antigens and mixed leukocyte culture reactivity. J Exp Med. 1968 Oct 1;128(4):623–637. doi: 10.1084/jem.128.4.623. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BACH F., HIRSCHHORN K. LYMPHOCYTE INTERACTION: A POTENTIAL HISTOCOMPATIBILITY TEST IN VITRO. Science. 1964 Feb 21;143(3608):813–814. doi: 10.1126/science.143.3608.813. [DOI] [PubMed] [Google Scholar]
- BAIN B., VAS M. R., LOWENSTEIN L. THE DEVELOPMENT OF LARGE IMMATURE MONONUCLEAR CELLS IN MIXED LEUKOCYTE CULTURES. Blood. 1964 Jan;23:108–116. [PubMed] [Google Scholar]
- Bach F. H., Amos D. B. Hu-1: Major histocompatibility locus in man. Science. 1967 Jun 16;156(3781):1506–1508. doi: 10.1126/science.156.3781.1506. [DOI] [PubMed] [Google Scholar]
- Bach J. F., Debray-Sachs M., Crosnier J., Kreis H., Dormont J. Correlation between mixed lymphocyte culture performed before renal transplantation and kidney function. Clin Exp Immunol. 1970 Jun;6(6):821–827. [PMC free article] [PubMed] [Google Scholar]
- Belzer F. O., Perkins H. A., Fortmann J. L., Kountz S. L., Salvatierra O., Cochrum K. C., Payne R. Is HL-A typing of clinical significance in cadaver renal transplantation? Lancet. 1974 Apr 27;1(7861):774–777. doi: 10.1016/s0140-6736(74)92842-6. [DOI] [PubMed] [Google Scholar]
- Cochrum K. C., Perkins H. A., Payne R. O., Kountz S. L., Belzer F. O. The correlation of MLC with graft survival. Transplant Proc. 1973 Mar;5(1):391–396. [PubMed] [Google Scholar]
- Eijsvoogel V. P., Du Bois R., Melief C. J., Zeylemaker W. P., Raat-Koning L., de Groot-Kooy L. Lymphocyte activation and destruction in vitro in relation to MLC and HL-A. Transplant Proc. 1973 Mar;5(1):415–420. [PubMed] [Google Scholar]
- Etheredge E. E., Shons A. R., Schmidtke J. R., Najarian J. S. Mixed leukocyte culture reactivity and renal transplantation in HL-A identical siblings. Surg Forum. 1973;24:304–306. [PubMed] [Google Scholar]
- Halgrimson C. G., Rapaport F. T., Terasaki P. I., Porter K. A., Andres G., Penn I., Putnam C. W., Starzl T. E. Net histocompatibility ratios (NHR) for clinical transplantation. Transplant Proc. 1971 Mar;3(1):140–144. [PMC free article] [PubMed] [Google Scholar]
- Kashiwagi N., Corman J., Iwatsuki S., Ishikawa M., Fiala J. M., Johansen T. S., Bethell D., Starzl T. E. Mixed lymphocyte culture and graft rejection. Surg Forum. 1973;24:345–348. [PMC free article] [PubMed] [Google Scholar]
- Yunis E. J., Amos D. B. Three closely linked genetic systems relevant to transplantation. Proc Natl Acad Sci U S A. 1971 Dec;68(12):3031–3035. doi: 10.1073/pnas.68.12.3031. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Rood J. J., Koch C. T., van Hooff J. P., van Leeuwen A., van den Tweel J. G., Frederiks E., Schippers H. M., Hendriks G., van der Steen G. J. Graft survival in unrelated donor--recipient pairs matched for MLC and HL-A. Transplant Proc. 1973 Mar;5(1):409–414. [PubMed] [Google Scholar]