Hyperacute Renal-Homograft Rejection in Man

Abstract

Biopsies of renal transplants taken within one hour after completion of vascular anastomoses revealed, in seven of 132 cases, the accumulation of large numbers of polymorphonuclear leukocytes within glomerular and peritubular capillaries, with eventual transplant failure in all cases. Serologic studies in all recipients demonstrated pre-existing antibodies reacting with human histocompatibility antigens. Heat eluates from three of four rejected kidneys also contained activity against human histocompatibility antigens. These findings suggest that serum antibody reacted with and became fixed to the histocompatibility antigens of the graft, thereby initiating an acute vascular reaction with early polymorphonuclear-leukocyte margination and progression to widespread capillary thrombosis.