Anti-major histocompatibility complex antibody removal assay in a swine model

A swine model of anti-MHC (SLA) immunization by skin grafting was established with the aim of removing preformed anti-MHC antibodies and preventing their resynthesis, in a situation close to that of hyperimmunization in humans. Plasma exchange therapy with or without associated immunosuppressive therapy was used. The feasibility of this animal model in terms of anti-MHC immunization and its therapeutic management have been proven. However, frequent early deaths of animals still mar the experimental protocol. Synchronization of plasma exchange and subsequent cyclophosphamide pulses seemed to abolish the antibody rebound phenomenon and cause marked drop of anti-MHC antibodies. Restimulation by a new skin graft is responsible for an intense polyclonal antibody stimulation, which suggests that we have to be careful in grafting patients with positive historical crossmatches and negative current ones.