Eluate analysis of anti-Bg a associated renal allograft rejection

Renal allograft rejection, following development of a positive indirect antiglobulin reaction, occurred in a multiply transfused recipient. Panel techniques confirmed both anti-Bga and anti-Kell antibodies. Recognition of the concordant antigenic specificity of the Bga and HL-A7 antigens led to an investigation of the potential role of this antibody in the rejection phenomenon. In the absence of serological cytotoxicity, a modified elution technique was used to directly obtain immunoglobulin from the rejected allograft. The eluate obtained displayed specificity for the Bga red blood cell antigen. The described technique affords an additional approach to the documentation of immunologically mediated graft rejection and obviates the limitations imposed by the absence of serological cytotoxicity. Emphasis is placed on the need for recognition of the relationship between red blood cell and HL-A antigens.