Humoral theory of transplantation: further evidence.

In the two and a half years following our initial paper on the humoral theory of transplantation, many publications have emerged in support of the hypothesis, with no studies in opposition. It is accepted that the role of antibodies is incontrovertible in hyperacute rejection, although what fraction of acute rejection is humoral remains to be determined. A recent large-scale prospective trial showing that transplant patients with antibodies have twice the failure rate as those without antibodies suggests that chronic rejection is also caused by antibodies. Together with serum creatinine, HLA antibodies are, therefore, the best predictor of graft function in kidney patients.