Correlation Between MLC Stimulation and Graft Survival in Living Related and Cadaver Transplants
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"Multiple MLC's" (parallel tests in recipient, donor and globulin-poor plasma) were performed in 211 consecutive transplant donor-recipient pairs(2) The two-way MLC's were performed on patients' lymphocytes before immunosuppression. All grafts regarded as "successful" were at risk for at least six months. Patients with a low MLC (Stimulation Index less than 8 times controls) usually had successful grafts (graft survival was 83% in related transplants and 76% in cadaver transplants). Patients with high MLC's had poor graft survival (0% graft survival in related transplants and 32% in cadaver transplants). An adjusted graft survival was calculated to exclude patients who died with normal renal function (serum creatinine less than 2 mg%). The adjusted graft survival was 91% for living related transplants and 88% for cadaver transplants. Falsely low MLC's occurred when the recipient's plasma contained low-titer cytotoxic antibodies. In 15 recipients of cadaver kidneys, the MLC in recipient plasma was significantly lower than MLC's in donor or globulin-poor plasma. Since the MLC when using cadaver donors was necessarily retrospective, the results were not known pre-transplant and all 15 grafts were rejected. In living related pairs, however, we were able to screen for such antibody activity and could avoid humoral presensitization and cellular compatibility.
Salvatierra Jr O, Vincenti F, Amend W, Potter D, Iwaki Y, Opelz G Ann Surg. 1980; 192(4):543-52.
PMID: 6448588 PMC: 1347002. DOI: 10.1097/00000658-198010000-00012.
Al-Safi S, Maddocks J Br J Clin Pharmacol. 1985; 19(1):105-7.
PMID: 3156615 PMC: 1463800. DOI: 10.1111/j.1365-2125.1985.tb02622.x.
Recent developments in dialysis and transplantation.
Gradus D, Fine R Indian J Pediatr. 1988; 55(4):559-73.
PMID: 3049336 DOI: 10.1007/BF02868439.
Immune potential in human uraemia. 2. Changes after regular haemodialysis therapy.
Byron P, Mallick N, Taylor G J Clin Pathol. 1976; 29(9):770-2.
PMID: 789408 PMC: 476176. DOI: 10.1136/jcp.29.9.770.
The impact of 1,000 renal transplants at one center.
Salvatierra Jr O, Feduska N, Cochrum K, Najarian J, Kountz S, Belzer F Ann Surg. 1977; 186(4):424-35.
PMID: 334095 PMC: 1396276. DOI: 10.1097/00000658-197710000-00004.