Serotyping for Homotransplantation IV Grouping and Evaluation of Lymphotoxic Sera*

Origins of the first HLA specificities

Following the discovery of the first histocompatibility antigen "MAC" in 1958, numerous independent laboratories began identifying HLA specificities with allo-antibodies. During the span of about a decade, 1958-1970, virtually all of the common HLA-A and HLA-B antigens were identified by various names and presented at the International Histocompatibility Workshops by means of different serological methods. Because many of the independently discovered specificities were found to be reactive to similar determinants on lymphocytes, it became necessary to classify the antigens by means of a standard method. The micro lymphocytotoxicity test was chosen to be the basis for future antigen testing, thereby allowing the various laboratories to confidently exchange sera. At the 1968 WHO Nomenclature meeting, the naming of the first antigen ultimately gave rise to the designation "HLA" in the human MHC Class I antigen system. This paper looks back upon the origins of the early serologically identified HLA specificities and their respective founders.

Chronic renal homograft function: correlation with histology and lymphocyte antigen matching

Renal function was studied in twenty-nine of thirty-four surviving renal allograft recipients from an initial group of sixty-four patients two years after transplantation. Mean clearances of inulin and PAH were, respectively, greater than and equal to half the donors’ initial predicted clearances. Minimum urine osmolality during water diuresis was greater, and maximum urine osmolality during hydropenia was less than normal, an effect attributable partly to enhanced solute load in a single transplanted kidney.

Patients with compatible donor-recipient lymphocyte antigens demonstrated statistically better function than those with one or more incompatibilities, although there was a definite degree of overlap between the two groups. In contrast, little correlation could be demonstrated between the cumulative histopathology and renal clearances.

Renal function in patients with compatible donors was statistically greater than half the donors’ initial predicted function. Serial increase in renal clearances was documented in one patient with a compatible donor. Serial decreases were demonstrated in two patients with incompatible donors. These findings suggest that hypertrophy of the denervated, transplanted kidney occurs when immune reaction is minimal.