ANTI-B CELL LYMPHOCYTOTOXIC ANTIBODIES IN KIDNEY TRANSPLANT RECIPIENTS

Abstract

Serial serum samples from 47 renal allotransplant recipients were screened for antiperipheral blood lymphocyte, anti-B [bone marrow-derived] cell and anti-[human Burkitt lymphoma]Daudi cell line antibodies. Various associations of these antibodies were observed in 28 patients. Anti-Daudi did not correlate with graft survival; anti-B, although they were often associated with anti-peripheral blood lymphocyte antibodies, showed the strongest correlation with chronic rejection (P = 0.00002). However anti-B cytotoxicity preceded or was concurrent with the onset of chronic rejection in only 53% of the cases. Antibodies were absent in 6 of 9 patients with irreversible acute rejection, but they usually appeared after transplant nephrectomy. Anti-B cell antibodies may play a role in the rejection process. In 15 of 17 recipients (88%), anti-B cell antibodies occurred during the 1st trimester after transplantation. These patients showed 20% 1 yr graft survival compared with 68% in those without antibodies at that time (P < 0.005).