DOSE RESPONSE STUDIES IN PASSIVE ENHANCEMENT OF RAT RENAL ALLOGRAFTS

Abstract
Dose response studies of passive enhancement of renal allografts in the rat were performed in two major histocompatibility locus incompatible strain combinations: (DA X Lewis)F1 to Lewis and (DA X Lewis) F1 to DA. The former represents a strong incompatibility and the latter a weak incompatibility, as judged by renal allograft survival in the unmodified recipient and by the ease of specific suppression of renal allograft rejection. Doses of enhancing serum between 4 ml and 10 µl were tested. In the weaker (DA X Lewis)F1 to DA model, 50 µl were as effective as 4 ml, and resulted in complete suppression of rejection and indefinite survival, whereas 10 µl produced a partial suppression of rejection in some rats. In the stronger (DA X Lewis) F1 to Lewis model, 50 µl produced a very pronounced suppression of rejection and was only slightly less effective than 4 ml, whereas 10 µl produced significant but only feeble suppression of rejection. Thus, 50 µl is the minimum effective dose for passive enhancement. On a volume to weight basis, this corresponded to 15-20 ml/human patient. This reduces the volumes of anti-HL-A sera that are likely to be needed for the clinical application of passive enhancement to levels that can realistically be provided on a widespread basis. Furthermore, the fact that as little as 50 µl of antiserum can protect a kidney allograft from rejection makes a peripheral action of enhancing serum unlikely. Since hyperacute rejection is a peripheral phenomenon, it may be possible to use doses of antiserum sufficient to induce enhancement but insufficient to cause significant antibody-mediated graft damage.