A Serological, Clinical and Morphological Study of Eight Kidney Grafts in Three Patients

Three patients with end stage renal failure are presented; the first received 2 and the second and third patients each received 3 kidney grafts. All three patients were given multiple blood transfusions and after the first graft all produced demonstrable cytotoxic antibody. A serological analysis is presented showing that Patient 1 produced antibody of additional HL—A specificity to the incompatibilities present in his two grafts, suggesting that multiple blood transfusions had formed a significant stimulus. In Patient 1 a strongly positive cross match was present with lymphocytes of the second donor and the second kidney was hyperacutely rejected. With the second and third kidneys of Patient 2 and the second kidney of Patient 3 the cross match was weakly positive and the kidneys did not achieve significant function and had to be removed at 10, 7 and 3 weeks respectively because of rejection. The third allograft kidney of Patient 3 appeared to have 4 antigens in common with the recipient and was serologically HL—A identical on all sera tested. The cross match was unequivocally negative and 61/2 months after transplantation the kidney continues to function well with standard immunosuppressive therapy.