RELATIONSHIP OF DONOR-SPECIFIC MIXED LYMPHOCYTE CULTURE REACTIVITY TO GRAFT FUNCTION IN RECIPIENTS OF CADAVERIC RENAL-ALLOGRAFTS

Abstract

The response of 12 cadaveric renal allograft recipients was serially studied in 1-way MLC [mixed lymphocyte culture] using the specific donor spleen lymphocytes as stimulating cells. The stimulation index (SI) progressively decreased between the 2nd and the 18th post-transplantation week in the presence of normal plasma. The appearance of MLC non-reactivity (SI of less than 2.3) correlated well with the achievement of excellent graft function. In 9 recipients allograft rejections did not occur once the non-reactive state in cultures with normal plasma was established. In 2 of the recipients reactivity reappeared after an interval of non-reactive phase. In both instances, rejection followed such reactivity and non-reactivity followed successful management of rejection. In 1 patient, severe irreversible allograft rejection occurred in spite of the appearance of an early MLC non-reactive phase. This patient developed donor-specific lymphocytotoxic antibodies and his rejection was perhaps of antibody mediated type. Donor-specific MLC reactivity may represent cellular immune response of host to an allograft and predict cellular allograft rejection.