Detection of serum-blocking factors by inhibition of allorosette formation in rats with long-surviving renal allografts following short-term postoperative ALS treatment

The influence of blood transfusion on cellular immunity

To evaluate the effect of transfusion on immunity, we studied some immunological parameters in 14 uremic patients treated with 3 blood transfusions (5 with HLA-compatible and 9 with random transfusions). Before transfusions 8/14 patients were DNCB-negative; both spontaneous and active E-rosettes were below normal range. The parameters of humoral immunity (S-Ig, C3, C4, IC, CRP) were normal. After both the first and second transfusions an increase in T- and B-lymphocytes was found. The third transfusion led to a more pronounced and prolonged immunosuppression in patients treated with compatible transfusions than in those treated with random transfusions. Our findings suggest that blood transfusion--HLA-compatible transfusion in particular--results in an impairment of the lymphocyte role.

Improved renal allograft survival after blood transfusion: a nonspecific, erythrocyte-mediated immunoregulatory process?

Phagocytosis of altered red blood cells in vitro by mononuclear phagocytic cells is followed by profound depression of bystander lymphocytes' responses to antigen. Rapid endocytosis of transfused erythrocytes in vivo may transiently impair mononuclear phagocytic cell function, resulting in immunological unresponsiveness as observed in vitro. Transplantation at this time would be predicted to benefit from this attenuation of recipient immunocompetence, resulting in improved graft survival.

[Suppression of the cell-mediated immunity in minor histoincompatible rat kidney allograft recipients (author's transl)]

To study the immunological status of recipients of major compatible and minor incompatible kidney allografts, we transplanted FiS and FLF1 kidneys into LEW rats. Most of the FiS kidneys were rejected within 55 days. Of 24 recipients, only 4 survived longer than 4 months. However, two-thirds of the FLF1 recipients survived longer than 4 months. The other third died with 64 days. During the first postoperation week a high level of lymphocytotoxin was detected in the serum of the FiS kidney recipients. Thereafter hardly any alternation of its titer was found, and no variation among the recipients of major histocompatible kidney allografts was shown. The FLF1 kidney recipients showed a low titer of antibody. The hemagglutinin titer showed the same trend as the lymphocytotoxin titer. A blocking serum factor could not be found in the serum of the kidney recipients with the microcytotoxity assay method or with the allorosette-formation inhibition test. Cellular immunity, which was studied with the GvH-reaction and microcytotoxity assay, was detected in the first postoperative week. However, this immunity was gradually supressed, and after 6 weeks was no longer to be found. This immunological status remained unchanged in the indefinitive surviving kidney-recipients in spite of antigen inoculation with two skin allografts of donor origin. This immunological status could be defined as "graft acceptance".