CYTOTOXIC ANTIBODIES AND ACCELLERATED REJECTION OF THE TRANSPLANTED RABBIT HEART THE EFFECT OF PRESENSITIZATION

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Abstract
In a group of 20 unmodified rabbit recipients receiving a cardiac allograft 7 rabbits formed lymphocytotoxic antibodies. The histological features of rejection were identical in all cases, independent of antibody formation. Thirteen rabbits were presensitized against the prospective heart donor by means of skin grafts and spleen cell injections, and the majority of these recipients were transplanted in the presence of donorreactive cytotoxic antibodies. Accellerated rejection took place in every recipient but the rapidity, of the reaction and the histological picture did not correlate well with the presence and potency of preexisting antibodies. Histological findings varied considerably including infiltration of mononuclear cells and polymorphonuclear leucocytes, extensive oedema and interstitial haemorrhage, and early degeneration of myofibres. Only one case of “hyperacute” clinical rejection was observed, in which the transplant was rejected within 2 1/2 hrs. Heavy deposits of gamma‐globulins were demonstrated by the fluorescent antibody method to be localized in the vessel walls of this transplant.