[The HLA system and diseases].
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Biomedical subjects
Publications and source records attributed to C Bouillenne.
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The kidneys of a patient were removed 3 months after a cadaveric allograft; histological examination revealed tuberculosis and malignant nephroangiosclerosis. When examined one year later, the graft exhibited lesions of glomerulonephritis and of vascular rejection. Immunoglobulin deposits were shown by immunofluorescence in the patient's own kidneys as well as in the graft; they were isolated by acid elution and in both cases had lymphocytotoxic activity in vitro. It is suggested that the target organ released histocompatibility antigen with formation of antigen antibody complexes which deposited in the patient's own kidneys.
The presence of anti-HL-A antibodies in a polytransfused person very often is a sign of a bad prognosis for survival of renal grafts or for the efficacity of leucocyte transfusion. In this paper, we describe the immunization of 5 patients who have been studied for several years. The number of units transfused as well as antigenic HL-A composition of these units are known for each patient. This enabled us to identify for each antigen, the number of blood units transfused (results given in %). Our observations confirm facts already described by several authors, study of voluntary programmed immunization, with the cells from the same donor. Furthermore, we are aware that there does not appear to be any direct relationship between proportion (absolute value) of the antigens received and specificity of antibodies. The time needed for an individual to become immunized does not appear to be related to the number of transfusions. This could lead to the modification of the criteria allowing to classify individuals as "responders" or "non-responders".
Patients receiving repeated transfusions sooner or later develop an anti-HL-A immunization. To prevent or to delay this immunization by transfusing "deleucocyted" blood appears in the long run, to be a vague hope. So, it became essential to use blood from donors typed for the HL-A system. In this study we have examined what would happen if a pool of 2,380 HL-A type donors were available for 110 recipients. Twenty five per cent of the recipients will have blood available from more than 5 donors with the same HL-A types as themselves, and 71% of them can receive blood from more than 5 donors sharing at least one antigen at each locus (and with no antigen known to be different between them).
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