Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion

I A al-Muzairai, A Innes, A Hillis, K N Stewart, J M Bone, G R Catto, A M Macleod

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The survival of a one haplotype, mismatched living-related renal allograft is improved by donor specific transfusion (DST) before transplantation although the mechanism is unclear. The major risk of DST is sensitization of the recipient to donor lymphocytes precluding transplantation. Fifty prospective recipients of a living related transplant received either DST with cyclosporin A (group I) or DST alone (group II). Persistent donor sensitization precluding transplantation occurred in no patients in group I but in six in group II (P less than 0.05). Ten of 14 of those who developed donor cytotoxicity had previously been pregnant or received greater than or equal to 10 third party transfusions compared with 11 of 36 without such a history (P less than 0.05). Alloantibodies detected by a cellular ELISA developed following DST in 29% patients and antiidiotypic antibodies detected by the short antiidiotypic assay (SAA) in 36%; antiidiotypic activity occurred more frequently in those given cyclosporin A (P less than 0.02). Potentiating activity in the SAA which occurred in sera from six patients after DST had no influence on transplant outcome. Persistent sensitization, particularly in potential transplant recipients who have been pregnant or received many transfusions, can be prevented by giving cyclosporin A with DST; the mechanisms of this effect may be the induction of antiidiotypic antibodies. Both alloantibodies and antiidiotypic antibodies are induced by DST and may protect a subsequent renal allograft from the specific donor.
Original languageEnglish
Pages (from-to)1057-63
Number of pages7
JournalKidney International
Volume35
Issue number4
Publication statusPublished - 1 Apr 1989

Fingerprint

Kidney Transplantation
Cyclosporine
Tissue Donors
Antibodies
Isoantibodies
Transplantation
Allografts
Transplants
Kidney
Haplotypes
History
Enzyme-Linked Immunosorbent Assay
Lymphocytes
Survival

Keywords

  • Antibodies
  • Antibody Formation
  • Blood Transfusion
  • Cyclosporins
  • Cytotoxicity, Immunologic
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Immunoglobulin Idiotypes
  • Isoantibodies
  • Kidney Transplantation
  • Lymphocytes
  • Tissue Donors

Cite this

al-Muzairai, I. A., Innes, A., Hillis, A., Stewart, K. N., Bone, J. M., Catto, G. R., & Macleod, A. M. (1989). Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion. Kidney International, 35(4), 1057-63.

Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion. / al-Muzairai, I A; Innes, A; Hillis, A; Stewart, K N; Bone, J M; Catto, G R; Macleod, A M.

In: Kidney International, Vol. 35, No. 4, 01.04.1989, p. 1057-63.

Research output: Contribution to journalArticle

al-Muzairai, IA, Innes, A, Hillis, A, Stewart, KN, Bone, JM, Catto, GR & Macleod, AM 1989, 'Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion', Kidney International, vol. 35, no. 4, pp. 1057-63.
al-Muzairai IA, Innes A, Hillis A, Stewart KN, Bone JM, Catto GR et al. Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion. Kidney International. 1989 Apr 1;35(4):1057-63.
al-Muzairai, I A ; Innes, A ; Hillis, A ; Stewart, K N ; Bone, J M ; Catto, G R ; Macleod, A M. / Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion. In: Kidney International. 1989 ; Vol. 35, No. 4. pp. 1057-63.
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abstract = "The survival of a one haplotype, mismatched living-related renal allograft is improved by donor specific transfusion (DST) before transplantation although the mechanism is unclear. The major risk of DST is sensitization of the recipient to donor lymphocytes precluding transplantation. Fifty prospective recipients of a living related transplant received either DST with cyclosporin A (group I) or DST alone (group II). Persistent donor sensitization precluding transplantation occurred in no patients in group I but in six in group II (P less than 0.05). Ten of 14 of those who developed donor cytotoxicity had previously been pregnant or received greater than or equal to 10 third party transfusions compared with 11 of 36 without such a history (P less than 0.05). Alloantibodies detected by a cellular ELISA developed following DST in 29{\%} patients and antiidiotypic antibodies detected by the short antiidiotypic assay (SAA) in 36{\%}; antiidiotypic activity occurred more frequently in those given cyclosporin A (P less than 0.02). Potentiating activity in the SAA which occurred in sera from six patients after DST had no influence on transplant outcome. Persistent sensitization, particularly in potential transplant recipients who have been pregnant or received many transfusions, can be prevented by giving cyclosporin A with DST; the mechanisms of this effect may be the induction of antiidiotypic antibodies. Both alloantibodies and antiidiotypic antibodies are induced by DST and may protect a subsequent renal allograft from the specific donor.",
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N2 - The survival of a one haplotype, mismatched living-related renal allograft is improved by donor specific transfusion (DST) before transplantation although the mechanism is unclear. The major risk of DST is sensitization of the recipient to donor lymphocytes precluding transplantation. Fifty prospective recipients of a living related transplant received either DST with cyclosporin A (group I) or DST alone (group II). Persistent donor sensitization precluding transplantation occurred in no patients in group I but in six in group II (P less than 0.05). Ten of 14 of those who developed donor cytotoxicity had previously been pregnant or received greater than or equal to 10 third party transfusions compared with 11 of 36 without such a history (P less than 0.05). Alloantibodies detected by a cellular ELISA developed following DST in 29% patients and antiidiotypic antibodies detected by the short antiidiotypic assay (SAA) in 36%; antiidiotypic activity occurred more frequently in those given cyclosporin A (P less than 0.02). Potentiating activity in the SAA which occurred in sera from six patients after DST had no influence on transplant outcome. Persistent sensitization, particularly in potential transplant recipients who have been pregnant or received many transfusions, can be prevented by giving cyclosporin A with DST; the mechanisms of this effect may be the induction of antiidiotypic antibodies. Both alloantibodies and antiidiotypic antibodies are induced by DST and may protect a subsequent renal allograft from the specific donor.

AB - The survival of a one haplotype, mismatched living-related renal allograft is improved by donor specific transfusion (DST) before transplantation although the mechanism is unclear. The major risk of DST is sensitization of the recipient to donor lymphocytes precluding transplantation. Fifty prospective recipients of a living related transplant received either DST with cyclosporin A (group I) or DST alone (group II). Persistent donor sensitization precluding transplantation occurred in no patients in group I but in six in group II (P less than 0.05). Ten of 14 of those who developed donor cytotoxicity had previously been pregnant or received greater than or equal to 10 third party transfusions compared with 11 of 36 without such a history (P less than 0.05). Alloantibodies detected by a cellular ELISA developed following DST in 29% patients and antiidiotypic antibodies detected by the short antiidiotypic assay (SAA) in 36%; antiidiotypic activity occurred more frequently in those given cyclosporin A (P less than 0.02). Potentiating activity in the SAA which occurred in sera from six patients after DST had no influence on transplant outcome. Persistent sensitization, particularly in potential transplant recipients who have been pregnant or received many transfusions, can be prevented by giving cyclosporin A with DST; the mechanisms of this effect may be the induction of antiidiotypic antibodies. Both alloantibodies and antiidiotypic antibodies are induced by DST and may protect a subsequent renal allograft from the specific donor.

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