Effect of donor specific antigen on graft survival

点击翻译按钮获取中文摘要

Donor-specific transfusion (DST) had once been widely accepted to improve living-related renal allograft survival. Previous studies have reported that transfusion can induce suppressor cell and/or anti-idiotypic antibodies. The aim of this study was to clarify the mechanism of effect of DST on renal allograft survival.The prospective kidney recipient received transfusion of the respective donors whole blood of 100ml at 1,8 and 15 days after its storage. During DST,patients received cyclosporine to minimize sensitization. Peripheral blood lymphocytes were analyzed by flowcytometer for the presence of surface antigenes using monoclonal antibodies.The percentage of CD8^+ cells rose significantly 1 week after the initial DST and was sustained throughout the remainder of the study, leading to a decreased CD4^+/CD8^+ cells ratio. The percentage of HLA-DR^+ cells also increased after DST.These results differ partly form those of Lenhard et al who studied the effect of blood transfusion on suppressor cells in hemodialysis patients. They showed an increased percentage of HLA-DR^+ cells as we did, but a decrease in OKT4/OKT8 ratio, concluding that monocytes act as suppressor cells in the immediate posttransfusion period.Increase in CD11b^+/CD8^+ cells in addition to increase in CD8^+ cells this study suggests participation of suppressor T cell in immunological effects of DST combined with CyA.To define whether or not DST combined with CyA still maintains immunologically beneficial effects, the MLR suppressor cell assay was performed, in which three of six patients were positive.The present study is preliminary because of the restricted number of patients studied. These results, however, suggest that DST combined with CyA can still induce suppressor cells while minimizing the sensitization.