Histocompatibility in cardiac transplantation with particular reference to immunopathology of positive serologic crossmatch

Gurmukh Singh, Mark Thompson, Bartley Griffith, Robert Bernstein, Bruce S. Rabin, Robert Hardesty, Michael Nalesnik, Henry T. Bahnson

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Cardiac allografting was carried out in 33 patients during the past 2 years. Twenty-one (64%) of the patients are alive and others lived for different periods after transplantation. The number of HLA-AB and HLA-DR antigens matched or mismatched was not significantly different between the surviving and deceased patients. However, 100% (4 of the 4) of the patients with a positive serum crossmatch with donor T lymphocytes are deceased as compared to the 25% (7 of the 28) mortality rate for crossmatch-negative patients. All four of the deceased patients with a positive crossmatch had demonstrable deposition of immunoglobulins in the capillaries of the donor heart at autopsy, whereas no immunoglobulin or fibrinogen deposition was seen in the hearts of crossmatch-negative patients. Three of the four patients with positive crossmatches had sera cytotoxic to lymphocytes of more than 25% of the persons, of a 42 member panel, whereas in the remaining one the serum was cytotoxic to less than 5% of the panel members. In crossmatch-negative patients, the sera were cytotoxic to less than 20% of the panel members with one exception. The relevance of cytotoxic antibodies to lymphocytes of panel members, crossmatch, and tissue deposition of immunoglobulins is discussed.

Original languageEnglish (US)
Pages (from-to)56-66
Number of pages11
JournalClinical Immunology and Immunopathology
Volume28
Issue number1
DOIs
StatePublished - Jul 1983
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pathology and Forensic Medicine
  • Immunology

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