Pretransplant predictors in renal transplantation

We have prospectively studied the predictive value of three tests commonly used in transplant units (mixed lymphocyte culture, phytohemagglutinin-induced transformation, and skin testing with recall antigens), and their correlation with rejection and kidney loss. Thirty-five transplant recipients provided complete data for analysis. The results of mixed lymphocyte culture reactivity, phytohemagglutinin-induced transformation, and skin reactivity to recall antigens were similar and did not predict or discriminate between the patients that had few or many rejections, nor between those that kept or lost their allografts. Nonetheless, patients with a very high mixed lymphocyte culture stimulation index (above 3) had higher morbidity and mortality than those with a nonreactive mixed lymphocyte culture. Pretransplant mixed lymphocyte culture may give more important information than nonspecific immunologic tests regarding allograft outcome.