Association of Fc receptor-blocking antibodies and human renal-transplant survival

Alison Murray MacLeod, R.J. Mason, Keith Nicol Stewart, D.A. Power, W.G. Shewan, N. Edward, G.R.D. Catto

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29 Citations (Scopus)

Abstract

Antibodies to B lymphocytes were monitored in previously transfused recipients of cadaver donor renal allografts. Forty-three patients were investigated before transplantation and in 20 of these the development of antibodies post-transplant was also studied. B lymphocyte antibodies were detected by lymphocytotoxicity and EA inhibition (EAI) against donor, normal panel, and leukemic B lymphocytes (CLL). The latter assay detects Fc receptor-blocking antibodies.

Eighty-five percent (11 of 13) of those with pretrans-plant EAI against donor lymphocytes had grafts which survived for 1 year compared with only 30% (6 of 20) of those without such antibodies (P < 0.01). Similarly 74% (14 of 19) of those with, but only 38% (9 of 24) of those without, antinormal panel EAI had grafts which survived for 1 year (P < 0.05). Seventy-seven percent (17 of 22) of those with EAI against the CLL panel, but only 29% (6 of 21) of those without, had grafts surviving for 1 year (P < 0.01). When EAI developed only post-transplant against any type of target lymphocyte, the graft had invariably failed by 1 year. If EAI had also occurred pretransplant, however, the favorable graft outcome associated with that persisted. EAI against both sets of panel lymphocytes was not directed against lymphocytes bearing any particular HLA-DR specificity, suggesting that these EA-inhibiting antibodies were not directed against classically defined HLR-DR antigens. The sera which demonstrated EAI were not necessarily the same sera which showed lymphocytotoxic activity, thus indicating the heterogeneous nature of B lymphocyte antibodies. Lymphocytotoxic antibodies were detected relatively infrequently pre- and post-transplant and no statistically significant correlation could be made with al-lograft survival.

This study demonstrates that the development of EAI post-transplant correlates with poor renal allograft survival and shows that pretransplant Fc receptor-blocking antibodies are associated with improved graft survival.
Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalTransplantation
Volume34
Issue number5
Publication statusPublished - Nov 1982

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