Immunological monitoring of long-surviving renal transplant recipients.
In this study a variety of cell-mediated immunity responses were performed in long-term (2 to 12 year) human leukocyte antigen-A (HLA) nonidentical renal transplant patients. All patients showed mixed lymphocyte culture (MLC) stimulation against donor, indicating a lack of tolerance. Of successful long-term transplant patients, 73 percent showed high serum levels of MLC-blocking activity. A consistent association of successful long-term transplantation and a specific defect in recipient ability to generate cytotoxic cells against donor was seen at the 8 to 12 year level. A close association of lymphocyte-dependent activity (LDA) and clinical chronic rejection was found, and LDA could be identified prior to the onset of clinical chronic rejection in most cases. Four patients had a positive LDA assay prior to transplant and all four went on to develop chronic rejection. Recipients taking immunosuppressive drugs within 24 hours of testing had a deficient capability to generate cytotoxic effector cells against indifferent individuals. These findings demonstrate a consistent association of in vitro cell-mediated immunity parameters and in vivo transplant function and may represent a valuable immunological monitoring system for long-term recipient follow-up.
D000906:Antibodies / Q000032:analysis; D003601:Cytotoxicity Tests, Immunologic; D006084:Graft Rejection; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007158:Immunologic Techniques; D066298:In Vitro Techniques; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008214:Lymphocytes / Q000276:immunology
D000906:Antibodies; D006680:HLA Antigens