The Role of Histocompatibilty Antigens in Clinical Transplantation

  • Kent C. Cochrum
  • Deanne M. Hanes


Controversy surrounding the influence of HLA-A and -B matching in clinical kidney transplantation has not abated since its inception. Clearly, the excellent graft survival of HLA-identical siblings seemed to underline the efficacy of histocompatibility testing. However, HLA-A and -B matching in unrelated donor-recipient pairs, particularly in heterogeneous populations, has not been as successful as anticipated. HLA-D matching, as evidenced by mixed-lymphocyte culture (MLC), has proven to be an excellent indication of graft survival especially in living-related situations. Recent developments, i.e., DRw typing and the beneficial effects of blood transfusions, appear to offer evidence of even better graft survival. In this chapter, we will relate our experience with donor-recipient matching in renal transplants and attempt to place our results in some perspective with evidence from other centers.


Graft Survival Histocompatibility Antigen Clinical Transplantation Mixed Lymphocyte Culture Renal Allograft Rejection 
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  1. Abouna, G.M., Barabas, A.Z., Pazderka, V., Boyd, N., Vetters, J.M. Kinniburgh, D.W., Lao, V.S., Shlaut, J., Kovithavongs, T., and Dossetor, J.B., 1977, Effect of pretreatment with multiple blood transfusions and with skin grafts on the survival of renal allografts in mongrel dogs, Transplant. Proc. 9:265.PubMedGoogle Scholar
  2. Batchelor, J.R., French, M.E., Camerons, J.S., Ellis, F., Bewick, M., and Ogg, C.S., 1970, Immunological enhancement of human kidney grafts, Lancet 2:1007.PubMedCrossRefGoogle Scholar
  3. Brynger, H., Frisk, B., Ahlmen, J., Blohme, I., and Sandberg, L., 1977, Blood transfusion and primary graft survival in male recipients, Scand. J. Urol. Nephrol. (Suppl.) 42:76.Google Scholar
  4. Cerilli, J., Newhouse, Y., and Williams, M.A., 1978, The correlation of tissue typing, mixed lymphocyte culture and related donor renal allograft survival, Transplant. Proc. 10:953.PubMedGoogle Scholar
  5. Cochrum, K.C., Perkins, H.A., Payne, R.O., Kountz, S., and Beizer, F.O., 1973, The correlation of MLC with graft survival, Transplant. Proc. 5:391.PubMedGoogle Scholar
  6. Cochrum, K.C., Salvatierra, O., Perkins, H.A., and Beizer, F.O., 1975, MLC testing in renal transplantation, Transplant. Proc. 3:659.Google Scholar
  7. Cochrum, K.C., Hanes, D., Potter, D., Vincenti, F., Amend, W., Feduska, N., Perkins, H., and Salvatierra, O., 1979, Donor-specific blood transfusions in HLA-D disparate 1-haplotype related allografts, Transplant. Proc. 11:1903.PubMedGoogle Scholar
  8. d’Apice, A.J.F., and Tait, B.D., 1979, The positive B cell cross match: A marker of active enhancement?, Transplant. Proc. 11:954.Google Scholar
  9. Ettenger, R.B., Terasaki, P.I., and Opelz, G., 1976a, Successful renal allografts across a positive cross-match for donor B lymphocyte alloantigens, Lancet 2:56.CrossRefGoogle Scholar
  10. Ettenger, R.B., Teraski, P.I., and Ting, A., 1976b, Anti-B lymphocytotoxins in the renal allograft rejection. N. Engl. J. Med. 295:305.PubMedCrossRefGoogle Scholar
  11. Fabre, J.W., and Morris, P.J., 1972a, The effect of donor strain blood pretreatment on renal allograft rejection in rats, Transplantation 14:608.PubMedCrossRefGoogle Scholar
  12. Fabre, J.W., and Morris, P.J., 1972b, The mechanism of specific immunosuppression of renal allograft rejection by donor strain blood, Transplantation 14:638.Google Scholar
  13. Feduska, N.J., Vincenti, F., Amend, W., Duca, R., Cochrum K., and Salvatierra, O., 1979, Do blood transfusions enhance the possibility of a compatible transplant?, Transplantation 27:35.PubMedCrossRefGoogle Scholar
  14. Ferrara, G.B., Tusi, R., Longo, A., Castellanii, A., Viviani, C., and Carminati, G., 1978, A safe blood transfusion procedure for immunization against major histocompatibility complex determinants in man, Transplantation 26:150.PubMedCrossRefGoogle Scholar
  15. Festenstein, H., Sachs, J.A., Paris, A.M.I., Pegrum, G.D., and Moorhead, J.F., 1976, Influence of HLA matching and blood-transfusion on outcome of 502 London Transplant Group renal-graft recipients, Lancet 1:157.PubMedCrossRefGoogle Scholar
  16. Fuller, T.C., Delmonico, F.L., Cosimi, A.B., Huggins, C.E., King, M., and Russell, P.S., 1977, Effects of various types of RBC transfusions on HLA alloimmunization and renal allograft survival, Transplant. Proc. 9:117.PubMedGoogle Scholar
  17. Garovoy, M.R., Person, A., and Carpenter, C.B., 1978, Correlation of mixed lymphocyte culture (MLC) reactivity and graft survival in 1-haplotype matched recipients, Proc. Dialysis Transplant. Forum 8:74.Google Scholar
  18. Halasz, N.A., Orloff, M.J., and Hirose, E., 1964, Increased survival of renal homografts in dogs after injection of graft donor blood, Transplantation 2:453.PubMedCrossRefGoogle Scholar
  19. Iwaki, Y., Terasaki, P.I., and Park, M.S., 1978, Enhancement of human kidney allografts by cold B-lymphocyte cytotoxins, Lancet 1:1228.PubMedCrossRefGoogle Scholar
  20. Jenkins, A.L., and Woodruff, M.F.A., 1971, Specific immunosuppression of cardiac allograft rejection in rats, Transplantation 12:57.PubMedCrossRefGoogle Scholar
  21. Marquet, R.L., Heystek, G.R., and Timbergen, W.J.,, 1971, Specific inhibition of organ allograft rejection by donor blood, Transplant. Proc. 3:708.PubMedGoogle Scholar
  22. Morris, P.J., Ting, A., Oliver, D.I., Bishop, M., Williams, K., and Dunhill, M.S., 1977, Renal transplantation and a positive serological crossmatch, Lancet 2:1288.CrossRefGoogle Scholar
  23. Newton, W.T., and Anderson, C.B., 1973, Planned preimmunization of renal allograft recipients, Surgery 74:430.PubMedGoogle Scholar
  24. Obertop, H., Jeckel, J., Vriesendorp, H.M., MacDicken, I., and Westbrock, D.L., 1975, The effect of donor blood on renal allograft survival in DL-A typed beagle littermates, Transplantation 20:49.PubMedCrossRefGoogle Scholar
  25. Opelz, G., and Teraski, P.I., 1978, Absence of immunization effect in human kidney retransplantation, N. Engl. J. Med. 299:369.PubMedCrossRefGoogle Scholar
  26. Opelz, G., Sengar, D.P.S., Mickey, M.R., and Terasaki, P.I., 1973, Effect of blood transfusions on subsequent kidney transplants, Transplant. Proc. 5:253.PubMedGoogle Scholar
  27. Persijn, G.G., Gabb, B.W., van Leeuwen, A., Nagtegaal, A., Hoogeboom, J., and van Rood, J.J., 1978, Matching for HLA antigens of A, B, and DR loci in renal transplantation by Eurotransplant, Lancet 1:1278.PubMedCrossRefGoogle Scholar
  28. Rapaport, F.T., Dausset, J., Lawrence, H.S., and Converse, J.M., 1968, Enhancement of skin allograft survival in man, Surgery 64:25.PubMedGoogle Scholar
  29. Ringden, O., and Berg, B., 1977, Correlation between magnitude of MLC and kidney graft survival in intrafamilial transplantation, Tissue Antigens 10:364.PubMedCrossRefGoogle Scholar
  30. Salvatierra, O., Perkins, H.A., Amend, W., Feduska, N., Duca, R.M., Potter, D.E., and Cochrum, K.C., 1977, The influence of presensitization on graft survival, Surgery 81:146.PubMedGoogle Scholar
  31. Solheim, B.G., Flatmark, A., Jervell, J., and Arnesen, E., 1977, Influence of blood transfusions on kidney transplant and uremic patient survival, Scand. J. Urol. Nephrol. (Suppl.) 42:65.Google Scholar
  32. Ting, A., and Morris, P.J., 1978, Cold and warm B cell antibodies in renal transplantation, Lancet 2:478.PubMedCrossRefGoogle Scholar
  33. van Es., A.A., Marquet, R.L., van Rood, J.J., Kalff, M.W., and Balner, H., 1977, Blood transfusions induce prolonged kidney allograft survival in rhesus monkeys, Lancet 1:506.PubMedGoogle Scholar
  34. van Hooff, J.P., Hendriks, G.F., Schippers, H.M.A., and van Rood, J.J., 1974, Influence of possible HLA haploidentity on renal-graft survival in Eurotransplant, Lancet 2:1130.CrossRefGoogle Scholar
  35. van Rood, J.J., Persijn, G.G., van Leeuwen, A., Goulmy, E., and Gabb, B.W., 1979, A new strategy to improve kidney graft survival: The induction of CML non-responsiveness, Transplant. Proc. 11:736.PubMedGoogle Scholar
  36. Vincenti, F., Duca, R.M., Amend, W., Perkins, H.A., Cochrum, K.C., Feduska, N.J., and Salvatierra, O., 1978, Immunologic factors determining survival of cadaver kidney transplants, N. Engl. J. Med. 299:793.PubMedCrossRefGoogle Scholar
  37. Walker, J., Opelz, G., and Terasaki, P.I., 1978, Correlation of MLC response with graft survival in cadaver and related donor kidney transplants, Transplant. Proc. 10:949.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1981

Authors and Affiliations

  • Kent C. Cochrum
    • 1
  • Deanne M. Hanes
    • 1
  1. 1.Department of SurgeryUniversity of CaliforniaSan FranciscoUSA

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