CHARACTERIZATION OF LYMPHOCYTOTOXIC ANTIBODIES IN RENAL TRANSPLANTATION

Abstract

Anti-B cell, anti-T cell, and antiperipheral blood lymphocyte antibodies were investigated in the sera from 115 cadaveric kidney graft recipients pre- and post-transplantation. These antibodies were characterized: optimal temperature for cytotoxicity (4.degree. C or 22.degree. C), Ig class (IgG or IgM), and reactivity after platelet absorption and thereafter defined according to their influence on the graft survival. Patients with IgM anti-B cell antibodies, reacting mostly at 4.degree. C, the activity of which could not be removed by platelet absorption, have a prognosis of the graft as good as those with no antibody, i.e., the graft function (serum creatinine and rejection severity) at 3 yr was comparable between those 2 groups. When the anti-B cell antibodies unabsorbable on platelets are of IgG class and detected at 4.degree. C and 22.degree. C, the graft outcome is poorer (P < 0.025 at 3 mo.). A similar prognosis is observed in patients with antiperipheral blood lymphocyte antibodies of IgG or IgM class, absorbable or not on platelets (P < 0.05). Lymphocytotoxic antibodies of the IgG class are always associated with a poor graft outcome. The cold IgM class anti-B cell antibodies are not associated with graft failure but no enhancing effect could be seen.