PubMed · 1101473
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L A Manson, W K Silvers. 1975. Obituary.. https://doi.org/10.1097/00007890-197507000-00001
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The low reactivity to donor alloantigens reported in PBL from kidney transplant recipients might be related to clonal deletion and/or suppression of donor-specific alloreactive cells. To discriminate between these two hypotheses, we quantified the number of IL-2 secreting cells (IL-2-SC) and of cytotoxic precursors (CTLp) in the T cells from tolerant recipients when stimulated with either donor specific or nonrelated third-party LCL. To eliminate the irrelevant reactivity, we used as responding cells high-density T cells that had been depleted of such reactivity by 4 days preculture with autologous lymphoblastoid cell line in the presence of bromodeoxyuridine. Thus, frequencies of IL-2-SC and CTLp specifically directed at alloantigens could be measured. In 11 recipients, there was no strong decrease in the frequency of donor-reactive T cells when compared to the frequency of those directed at a third-party lymphoblastoid cell line, either for IL-2-SC (tested in 11 patients) or for CTLp (tested in 6 patients). In three cases of seven, a suppression was observed only when T cells were stimulated by donor cells. These data suggest that donor-reactive cells are still present in PBL of kidney-transplant recipients tested from 6 mo to 4 y posttransplantation. Moreover, suppression of donor-specific cells can be demonstrated in peripheral T cells of some recipients, which may account in part for the absence of rejection.
The kidney transplantation, as a method of medical treatment, could not be developed faster in our country for many years. A number of demands for transplantation grows much faster than our modest capability. The similar, but in a rather smaller degree, this problem occurs in some other countries in the world. The main cause is: the organization of corpse collecting and the conservatism of doctors. The latter problem, in the countries of western hemisphere, is surpassed more easily by a doctor codex and a legal obligation that involves doctors actively in this process, which is not the case in our country. The organization of corpse collecting in some states of the USA is highly developed, but however it does not give sufficient number of organs for the cadaveric transplantation. New, additional possibilities are found: the taking of even organs (kidneys) from alive unrelated donors, spouses, which excludes the possibility of greed and gives, only in the USA, about 1.500 additional alive transplantations per year. The complementary medical attitude towards the increasing of number of cadaveric transplantations is: considerably freely taking of kidneys from cadavers without tissue compatibility, only with the compatibility of blood groups of ABO system. Since the immunological criteria, in our country, are very intensified by the Zagreb immunology group, e.g. from 75-100% for alive transplantation, or the minimum of 50% tissue compatibility for cadaveric transplantation, this old-fashioned attitude has considerably lowered the number of transplantations in our country.(ABSTRACT TRUNCATED AT 250 WORDS)