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MLC compatibility, HLA-D and DR typing in cadaver kidney transplantations
Insights
Low mixed lymphocyte culture (MLC) reactivity between kidney recipients and donors, indicating human leukocyte antigen (HLA)-D compatibility, strongly correlated with successful kidney transplant graft survival.
Area of Science:
- Immunogenetics
- Transplantation immunology
- Clinical immunology
Background:
- Kidney transplant success is influenced by donor-recipient compatibility.
- Human Leukocyte Antigen (HLA) matching plays a crucial role in transplant outcomes.
- Cryopreservation of lymphocytes allows for retrospective immunological assessments.
Purpose of the Study:
- To investigate the correlation between mixed lymphocyte culture (MLC) reactivity and HLA-D compatibility with kidney graft survival.
- To assess the utility of cryopreserved lymphocytes for HLA-DR typing.
- To evaluate the impact of HLA-A, B matching and pretransplant blood transfusions on graft survival.
Main Methods:
- Cryopreservation of spleen lymphocytes from kidney donors for one year.
- Determination of HLA-D types for 33 donors and 39 recipients.
- Assay of recipient lymphocyte reactivity against donor lymphocytes using MLC.
- HLA-DR typing performed on donor-recipient pairs, including repeat typing on cryopreserved cells.
- Statistical analysis to correlate immunological findings with graft survival.
Main Results:
- A significant correlation was observed between specifically low recipient lymphocyte reactivity against donor lymphocytes and enhanced graft survival.
- Strong correlation found between HLA-D compatibility and kidney graft survival.
- Significant correlation between HLA-DR compatibility and graft survival was established.
- HLA-A, B matching and pretransplant blood transfusions did not show a significant impact on graft survival in this study.
Conclusions:
- Specifically low MLC reactivity and HLA-D/DR compatibility are strong predictors of kidney transplant success.
- Cryopreserved lymphocytes are valuable for reliable HLA-DR typing.
- Focusing on HLA-D/DR compatibility may improve kidney transplant outcomes.
Abstract:
During a period of one year, spleen lymphocytes from cadaver kidney donors were cryopreserved for later investigations. The HLA-D types of 33 donors and the corresponding 39 recipients were determined in six experiments and the reactivities of the lymphocytes of the individual recipients towards those of the donors were assayed in MLC. The MLC experiments included a sufficient number of unrelated responders and stimulators to allow an estimate of the specific MLC reactivity by the stabilized relative response. A strong and significant correlation was found between specifically low reactivity of recipient lymphocytes against donor lymphocytes and graft survival. A correlation was also found between HLA-D compatibility and graft survival. DR typing was performed on the same donor-recipient pairs. In sixteen cases the DR typing of the recipients was initially a technical failure but successful when repeated on cryopreserved lymphocytes. There was a significant correlation between HLA-DR compatibility and graft survival. HLA-A, B matching and pretransplant blood transfusion did not significantly affect graft survival in this material.