HUMORAL IMMUNITY IN RENAL TRANSPLANTATION

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Abstract
A Fab2 fragment blocking assay was used with cultured human B lymphoid cells and peripheral lymphocytes as targets: cytotoxic antibodies to Ia-like antigens, to HLA-A,B,C antigens, to lymphocyte structures other than these 2 types of histocompatibility antigens were identified in serial post-transplant sera from 18 [human] renal allograft recipients. Multiple combinations of these 3 types of antibodies were seen in 78% of the sera. A higher reactivity and higher titers of antibodies were found in patients with graft failure from rejection. The occurrence of anti-HLA-A,B,C or anti-Ia-like antibodies did not show any relationship to graft outcome. Cytotoxic antibodies to other antigens (referred to as non-HLA antibodies) were detected in 5 of the 6 patients with graft failure and in only 1 patient with graft survival. In this latter patient, non-HLA antibodies occurred with a chronic rejection episode and were no longer detectable when the rejection ceased. The Fab2 fragment blocking assay apparently is a useful method to identify antibodies to multiple specificities in sera from kidney graft recipients. Non-HLA cytotoxic antibodies may be associated with graft rejection.