Serotyping for Homotransplantation
05 Sep 1968-The New England Journal of Medicine (Massachusetts Medical Society)-Vol. 279, Iss: 10, pp 501-506
TL;DR: During the past four years 104 patients who had received kidneys from either living unrelated or cadaver donors were typed and analyzed, to assess the effect of matching on endogenous crea...
Abstract: During the past four years 104 patients who had received kidneys from either living unrelated or cadaver donors were typed and analyzed, to assess the effect of matching on endogenous crea...
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TL;DR: It is now necessary to distinguish antibodies against T and B lymphocytes and those that react in cold and in warm conditions, previously thought to be detectable only by lymphocyte-determined (LD) tests.
Abstract: The microdroplet lymphocyte cytotoxicity test is universally accepted as the standard test for HLA antigen determination. An update of the technical details of the test is given, based on the authors’ testing 160,000 persons. Methods for quality control of the test as well as reproducibility data are provided. International standardization of the specificities has been accomplished by seven international workshops and a continuous cell exchange involving testing of 108 cells since 1974 by as many as 180 laboratories. The test has recently become applicable to the detection of HLA-D determinants, previously thought to be detectable only by lymphocyte-determined (LD) tests. Purified peripheral blood lymphocytes are reacted with antisera from which HLA-A, -B, and -C antibodies have been removed. B lymphocytes were found to be smaller than T lymphocytes by Coulter counter sizing. The purity of cell suspensions enriched for B lymphocytes can be individually monitored, as shown by the reactions produced by 126 test samples. HLA-D antigens have a linkage disequilibrium with certain HLA-A and -B specificities as demonstrated by population and family studies. Haplotypes found in 34 parents of 18 families demonstrate the new haplotypes, which now consist of four antigens per haplotype. Studies of HLA-D frequencies in Caucasians, Negroes, and Orientals show a distinctive distribution in the races. B lymphocytes also appear to have an autoantigen against which autoantibodies are readily produced. The autoantibodies are more active against B than T lymphocytes and act most effectively at 5 C. Although they appear in many diseases, most notably in systemic lupus erythematosus, they also occur in 10% of normal males and females. In patients awaiting kidney transplants, antibodies against B lymphocytes are often found. Patients with cold B-cell antibodies (autoantibodies) were shown to have higher transplant survival rates than those with warm B-cell antibodies (allogeneic). Thus, in performing crossmatch tests it is now necessary to distinguish antibodies against T and B lymphocytes and those that react in cold and in warm conditions.
912 citations
University of Alberta1, Cedars-Sinai Medical Center2, Harvard University3, Johns Hopkins University4, Cleveland Clinic5, University of Arizona6, Hannover Medical School7, Mayo Clinic8, University of Pittsburgh9, University of Maryland, Baltimore10, University of Paris11, Washington University in St. Louis12, University of Alabama13, Westmead Hospital14, University of North Carolina at Chapel Hill15, University of Vienna16, Autonomous University of Barcelona17, NewYork–Presbyterian Hospital18, Cornell University19
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TL;DR: The results show that normal stem cells will repopulate the marrow in patients with aplastic anemia and demonstrate that long-term stable chimerism is possible in man.
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Abstract: The fluorescein diacetate-ethidium bromide (FDA-EB) fluorescence method, primarily used to determine viability of mammalian cells, was applied to several fungi species. Living fungi cells produced fluorochromasia, i.e., an intracellular accumulation of fluorescein which could be easily visualized as a green color under the U.V. microscope. Dead cells showed a red bright color due to ethidium bromide penetration. The FDA-EB test can be successfuly employed to assay yeast and yeast like cells viability since a good correlation was observed between this assay and the colony count technique. The main advantages of FDA-EB test are its speed, high sensitivity and simplicity.
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TL;DR: It is concluded that although survival in this series is associated with matching in marginal limits, many hazards which influence survival especially in the early 3 month period may be making it difficult to demonstrate the association.
Abstract: SUMMARYA total of 196 kidney transplant donors and recipients have been tested with a large panel of antisera and classified as to whether they are matched or mismatched for major leukocyte groups. The survival of the matched patients in comparison to the mismatched patients was then analyzed. Durin
164 citations
TL;DR: If the HL-A locus is to be considered the principal histocompatibility locus in man, it is clear that with kidney transplantation utilizing current immunosuppressive therapy an incompatibility for a single allele having any of the five antigens studied is not invariably deleterious.
Abstract: SUMMARYThe role of HL-A antigen compatibility in the clinical outcome of kidney transplantation was studied in 107 sibling to sibling and 147 parent to child transplants. As could be predicted on genetic grounds, certain sharp differences between the two genetic classes of donors were found. Leukocy
61 citations
TL;DR: It was shown that 52 dialyzed uremic patients and 49 patients who had been treated with immunosuppression for over 1 year did not possess more or less antigens than a random population of normal individuals.
Abstract: An attempt was made to determine whether 36 long-term kidney homograft recipients and their donors were compatible for 7 major leukocyte groups It was found that 21 of these recipients were surviving 2 to 3 years in spite of incompatibility for 1 or 2 major leukocyte antigens Survival of mismatched grafts does not itself indicate that the antigens being measured are not transplantation antigens, for it was shown that the 15 recipients with no groups of mismatch were clinically superior to those with group incompatibilities Moreover, histopathologic scores given to biopsy specimens taken 2 to 3 years after transplantation were significantly correlated with the number of group mismatches Because the leukocyte groups were determined by cytotoxicity reactions of peripheral blood lymphocytes, the results may have been influenced considerably by chimerism in chronically dialyzed uremic patients or change in lymphocyte antigenicity or susceptibility to lysis upon prolonged immunosuppressive treatment Although the possibility of these complications could not be ruled out in all instances, it was shown that 52 dialyzed uremic patients and 49 patients who had been treated with immunosuppression for over 1 year did not possess more or less antigens than a random population of normal individuals It is concluded that: (1) the major leukocyte antigens are histocompatibility antigens, and (2) since survival can be attained at times despite mismatches for these groups, the antigens are of intermediate strength and kidney homograft rejection may occur if excessive numbers of antigens are incompatible or if particular combinations of antigens are mismatched © 1966 by The Williams and Wilkins Co
56 citations