Reinforcement of cyclosporin A-induced red cell destruction by superoxide

To determine the mechanism of hemolysis following organ transplantation, we studied the effect of immunosuppressants and/or superoxide (SO) on the in vitro destruction of red cells. The immunosuppressants tested included cyclosporin A (CyA), deoxyspagarine (DSG), and FK506. SO was obtained from the hypoxanthine-xanthine oxidase reaction. Of the three immunosuppressants studied, only CyA affected the size of red cells and directly produced hemolysis in an isotonic buffer without the involvement of an immune mechanism. In addition, SO and CyA showed a synergistic effect on hemolysis during prolonged incubation. Catalase and allopurinol prevented hemolysis by counteracting the activity of SO. In that SO is produced in excess during the recovery of blood flow after organ transplantation, the prolonged contact of red cells with CyA and SO may be involved in the development and reinforcement of hemolysis in vivo.