Chronic Survival After Human Renal Homotransplantation Lymphocyte-Antigen Matching, Pathology and Influence of Thymectomy

Starzl, TE; Marchioro, Thomas L.; Terasaki, Paul I.; Porter, K. A.; Faris, Tanous D.; Herrmann, Thomas J.; Vredevoe, Donna L.; Hutt, Martin P.; Ogden, David A.; Waddell, William R.

doi:10.1097/00000658-196510000-00016

Cited by 88 publications

(13 citation statements)

References 44 publications

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“…Since the early reports of antidonor antibodies in the serum of the recipient before transplantation being a risk for hyperacute rejection, crossmatch‐positive patients have been denied access to kidney transplantation 1, 2. Unfortunately, a considerable number of candidates for kidney transplantation have alloantibodies and are unlikely to ever find a suitable (crossmatch negative) donor.…”

mentioning

confidence: 99%

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

Gao¹,

McAlister²,

Wright³

et al. 2004

Liver Transpl

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Outcomes may differ after kidney transplantation compared to combined liver-kidney transplantation. In animal models, distinct patterns of antidonor immunoglobulin (Ig) G subclasses are associated with either rejection or transplant tolerance. Flow cytometry has increased the sensitivity of antidonor immunoglobulin detection. We compared antidonor IgG subclass responses in kidney transplant recipients to those in recipients of liver or multiorgan grafts. In this study of 19 organ (kidney, liver, pancreas) transplantations, recipient serum incubated with donor splenocytes was tested by flow cytometry for the presence of IgM, IgG, or IgG subclass 1 -4. Sera before transplantation and 10 days and 100 days after transplantation were used. No differences were seen in antidonor IgM, IgG, or IgG subclass antibodies among recipients of kidney transplants and liver grafts or combination grafts, either before or after transplantation. IgG4 gradually but significantly increased after transplantation in all groups. High levels of antidonor IgG3 either before transplantation or produced after it were found in 3 kidney recipients who experienced acute rejection. No other patients experienced rejection, and no other increase in IgG3 was seen. In conclusion, antidonor IgG subclass profiles may be useful to distinguish populations at risk of rejection but they do not differentiate the immunological response after kidney transplantation from that after liver or combined transplantation. A late rise in antidonor IgG4 is consistent with decreased antidonor reactivity thought to occur late after transplantation. (Liver

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mentioning

confidence: 99%

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

Gao¹,

McAlister²,

Wright³

et al. 2004

Liver Transpl

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“…The presence of large lymphoid cells with many free cytoplasmic ribosomes has often been noted previously in human renal allografts (Galle & Montera, 1962;Hamburger et al, 1965;Starzl et al, 1965). These cells are characteristically found in the acute stage of the rejection of renal allografts in untreated animals .…”

Section: Discussionmentioning

confidence: 52%

“…Blood lymphocytes obtained from the patients and from their donors were tested against a panel of 65-121 different cytotoxic antisera in the presence of rabbit complement (Terasaki et al, 1965). Those antisera tending to act alike had been previously classed together by a computer factor analysis program into groups.…”

Section: Lymphocyte Typingmentioning

confidence: 99%

LIGHT AND ELECTRON MICROSCOPIC STUDY OF BIOPSIES FROM THIRTY‐THREE HUMAN RENAL ALLOGRAFTS AND AN ISOGRAFT 1³/₄–2¹/₂ YEARS AFTER TRANSPLANTATION*

Porter

Rendall

Stolinski

et al. 1966

Annals of the New York Academy of Sciences

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patients received renal allografts and two received renal isografts from living donors. The identical twins and 34 of the other patients are still alive .Of those that died, 27 did so in the first year and three in the second year after renal transplantation. The pathological changes found in the renal allografts from 29 of these dead patients have already been published Starzl et al., 1966).The present report is a preliminary account of the light and electron microscopic changes found in biopsies obtained about two years after transplantation from 33 of the 34 surviving renal allografts and from one of the two isografts. The histopathological findings in each transplant are correlated with the relationship of donor to recipient, with the degree of compatibility of donor and recipient as shown by lymphocyte typing, with the number of clinical rejection episodes experienced by the patient, and with renal function. MATERIALS AND METHODS PatientsEach case is denoted by a number prefixed by the letters LD, for the allograft recipients and IDT, for the identical twin. This same code has been used previously (Starzl, 1964;Starzl et al., 1966) and further details of any of the patients can be obtained by referring to these publications.In all but two of the patients, splenectomy and bilateral nephrectomy were performed at or before the time of transplantation. The exceptions were LD2 who retained his right kidney and IDT2 in whom splenectomy was unnecessary. The thymus was removed from 12 of the patients, four before, and eight between 250-520 days after transplantation.At the time of open biopsy, the identical twin was receiving no immunosuppressive or antihypertensive drugs. Of the 33 patients with renal allo-grafts, all were being given daily azathioprine, 24 were receiving 2.5-25 mg per day of prednisone, and 15 were being treated

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“…HLA matching in organ transplantation was first tested retrospectively (42) and prospectively (43) in live donor kidney recipients treated with azathioprine and prednisone, with or without adjunct antilymphocyte globulin. As had been predicted, HLA-matched allografts had the best survival and function, least dependence on maintenance prednisone, and fewest histopathologic abnormalities in routine 2-year postoperative biopsies (44).…”

Section: Discussionmentioning

confidence: 99%

Hla and Cross-Reactive Antigen Group Matching for Cadaver Kidney Allocation1

Starzl

Eliasziw

Gjertson³

et al. 1997

Transplantation

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Chronic Survival After Human Renal Homotransplantation Lymphocyte-Antigen Matching, Pathology and Influence of Thymectomy

Cited by 88 publications

References 44 publications

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

LIGHT AND ELECTRON MICROSCOPIC STUDY OF BIOPSIES FROM THIRTY‐THREE HUMAN RENAL ALLOGRAFTS AND AN ISOGRAFT 1³/₄–2¹/₂ YEARS AFTER TRANSPLANTATION*

Hla and Cross-Reactive Antigen Group Matching for Cadaver Kidney Allocation1

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Chronic Survival After Human Renal Homotransplantation Lymphocyte-Antigen Matching, Pathology and Influence of Thymectomy

Cited by 88 publications

References 44 publications

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

Immunoglobulin-G subclass antidonor reactivity in transplant recipients

LIGHT AND ELECTRON MICROSCOPIC STUDY OF BIOPSIES FROM THIRTY‐THREE HUMAN RENAL ALLOGRAFTS AND AN ISOGRAFT 13/4–21/2 YEARS AFTER TRANSPLANTATION*

Hla and Cross-Reactive Antigen Group Matching for Cadaver Kidney Allocation1

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LIGHT AND ELECTRON MICROSCOPIC STUDY OF BIOPSIES FROM THIRTY‐THREE HUMAN RENAL ALLOGRAFTS AND AN ISOGRAFT 1³/₄–2¹/₂ YEARS AFTER TRANSPLANTATION*