Retrospective screening for lymphocyte dependent antibody in recipients of renal transplants

Pretransplant sera from thirty two patients who had received cadaveric renal transplants were screened retrospectively for lymphocyte dependent antibody (LDA). An 18 hr ⁵¹ Cr release assay, using neat serum and an effector:target ratio of 10:1 was employed, each serum being screened against 10 normal target cells. Ten per cent of all reactions tested were positive, compared with 2% when ten normal sera were screened in the same way. No relationship between the presence of LDA pregraft, and the subsequent course of the renal allograft, was apparent in the group as a whole. Patients who had received blood transfusions and who developed LDA before transplantation, had marginally worse graft courses than transfused patients who did not develop LDA, but the difference was not significant. Eight male patients who had never been transfused, nevertheless were found to have LDA. Twelve patients were screened postoperatively for LDA, but only five out of 433 sera tested were positive. It appears that pregraft LDA do not influence the course of a subsequent renal transplant, nor does the appearance of LDA after transplantation allow prediction of acute rejection episodes.