Cell-mediated lympholysis studies in renal allograft recipients.

Cell-mediated lympholysis (CML) reactivity against the splenocytes of the kidney donor might be a good in vitro correlate of the homograft reaction. The present study was performed in an attempt to determine whether CML nonreactivity between unrelated donor-recipient combinations occur and, if so, under what conditions. We were able to show that CML nonreactivity occurs between unrelated donor-recipient combinations in 70% of the nonrejecting patients, whereas all of the rejecting patients were CML reactive. Patients with CML nonreactivity did clinically well more frequently than those that were CML reactive. The question as to whether or not such variables as HLA-A, B, and DR match and sex, the number of pretransplant blood transfusions, and the degree of presensitization, etc. predispose to the development of donor-specific CML nonreactivity was studied as well. Sex and compatibility for HLA-B antigens between donor and recipient might be such factors.