SUCCESSFUL KIDNEY TRANSPLANT IN PATIENT WITH POSITIVE CROSSMATCH DUE TO AUTOANTIBODIES

Abstract

Prior to kidney transplantation a young woman had lymphocytotoxic antibodies to an HL-A/mixed lymphocyte culture identical sib donor. The serum killed 75% of the lymphocytes at 22.degree. C, but was unreactive at 37.degree. C. At room temperature, it was cytotoxic for many lymphocytes of a random panel and reacted with the recipient''s own cells. Complement was required for cytotoxicity. Absorption with lymphocytes, but not with platelets, abolished the reaction. The antibodies disappeared spontaneously and the transplant was performed. There was no evidence of rejection, and at 6 mo. the kidney was in excellent condition. Cold-reactive lymphocyte specific autoantibodies causing a positive crossmatch could be distinguished from anti-HL-A antibodies and did not preclude a successful kidney transplant.