Accelerated graft loss: Association with presensitization to donor B-cell (Ia) antigens
Humoral presensitization to B-cell (Ia) antigens is associated with a high rate of early allograft failure, while lack of such presensitization is associated with favorable graft outcome. Our findings of adverse influence of presensitization to donor B-cell (Ia) antigens is at variance with the findings of Ettenger et al., who have recently reported stable graft function (serum creatinine <2 mg/100 ml at 1 month) in 9 of 15 recipients with a positive pretransplant B-cell cytotoxicity assay. The recent recognition that monocytes contaminating E-rosette-depleted B-cell-enriched populations and cold reactive cytotoxic antibodies absorbable with platelets and red cells may be responsible for extra reactions in the B-cell cytotoxicity assay introduces the possibility that some of the sera from patients studied by Ettenger et al. may not be recognizing B-cell alloantigens. The possibility that the inhibition of EA rosettes by cytotoxic negative sera may in some cases be due to some other yet unrecognized antigenic system in man cannot be excluded in our study.