A new in vitro approach to determine acquired tolerance in long-term kidney allograft recipients

Journal Article · Thu Nov 01 00:00:00 EST 1990 · Transplantation; (USA)

DOI:https://doi.org/10.1097/00007890-199011000-00009· OSTI ID:6169067

Reinsmoen, N L; Kaufman, D; Matas, A; Sutherland, D E; Najarian, J S; Bach, F H ^[1]

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1. Univ. of Minnesota, MN (USA)

Previous studies indicate some kidney allograft recipients treated with total lymphoid irradiation, cyclosporine, or conventional immunosuppressive therapy demonstrate specific proliferative unresponsiveness in mixed lymphocyte culture (MLC) to donor cells at various times posttransplant. To investigate possible donor-specific hyporeactivity, we have studied 3 patients treated with TLI whose grafts have survived longer than 10 years; 2 patients given the same immunosuppressive protocol but without TLI whose grafts have survived longer than 10 years; and 27 CsA-treated living-related donor and cadaver-allograft recipients 1 year posttransplant. We confirmed previous observations of hyporeactivity of some patients' cells to stimulation by donor cells. In addition, we identified hyporeactivity to stimulation by homozygous typing cells (HTCs) defining the HLA-Dw specificities of the donor cells for all 3 of the 3 TLI patients, 1 of the 2 non-TLI patients, and 9 of the 27 patients 1 year posttransplant. The LRD recipients with donor-specific hyporeactivity as defined by the HTC analysis demonstrated fewer rejection episodes (25% vs. 57%) and lower mean creatinine levels (1.18 vs 1.78 mg/dL) than patients without donor-specific hyporeactivity. These studies demonstrate the feasibility of monitoring the immune status of allograft recipients posttransplant by means of HTC analysis, eliminating the need for pretransplant specimens. This approach provides a possible means to assess which patients may have acquired donor-specific hyporeactivity to their kidney allograft and thus may require less immunosuppression.

• OSTI ID: 6169067
• Journal Information: Transplantation; (USA), Vol. 50:5; ISSN 0041-1337
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
GRAFT-HOST REACTION
COMBINED THERAPY
KIDNEYS
TRANSPLANTS
IMMUNOSUPPRESSIVE DRUGS
IRRADIATION
LYMPHATIC SYSTEM
LYMPHOCYTES
PATIENTS
SURVIVAL TIME
ANIMAL CELLS
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CONNECTIVE TISSUE CELLS
DRUGS
LEUKOCYTES
MATERIALS
ORGANS
SOMATIC CELLS
THERAPY
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