118 Abstracts

DR AND DR6 MATCHING-EFFECT ON CADAVER KIDNEY TRANSPLANT SURVIVAL. Luis H. Toledo-Pereyra, Theodore A. Reyman, and Jack W. Benson; Mount Carmel Mercy Hospital, Detroit. MI

In recent years, at our institution and others, tissue typing has expanded to include the HLA-DR locus as well as the HLA-A, B, and C loci. We have retrospectively reviewed 85 cases of cadaver renal transplantation to determine the effect of DR antigen matching, and DR6 compatibility, specifically, on the outcome of kidney transplantation. In 16 recipient-donor pairs, the DR6 antigen was only identified in the recipient. In eight recipient-donor pairs, the donor was positive for the DR6 antigen and the recipient was either positive or negative. In 61 pairs, both the donor and the recipient were identified to be negative for the DR6 antigen. The table below shows the l-yr actuarial graft and patient survival for each of the donor- rec ip ien t combinations (neg: negative, pos: positive). In summary, this preliminary evaluation of DR matching in our renal transplant program indicated a deleterious effect on graft survival when the recipient was not matched with the donor for the DR6 antigen. No statistical difference in graft survival was observed, however, between transplants with 0 or 1 DR antigen matches.

DR6 antigen 1-yr actuarial

Donor Recipient N Graft survival Patient survival

neg. pos. 16 33"5%3 NS pos, pos./neg. 8 62 .5%- neg. neg. 61 62.7%

DR matches 0 antigen match 48 58.4%~> 1 antigen match 32 46.6% NS

<.05 8 6 . 6 % > N S 87.5% NS 93,5%

88.9%, ,~ 100c~; ,7 Lxaa

FLOW CYTOMETRIC ANALYSIS OF ACTIVATED LYMPHOCYTES FROM TRANSPLANT RECIPIENTS. J. Anderson, D. Johnson, A. Landay, J. Williams, S. Economou, and H. Gebel; Rush-Medical Center, Chicago, IL

Peripheral blood was obtained from ten healthy individuals and five liver trans- plant recipients. Mononuclear cells were isolated, cultured with phytohemeag- glutinin (PHA) for 18 hr, and stained with fluorescein-conjugated anti-CD4 or anti-CD8. These cells were then simultaneously stained with phycoerythrin-con- jugated anti-CD25 (IL-2 receptor; IL2R). All samples were analyzed by two-color flow cytometry; doubly fluorescent cells were considered to be activated. In normals, the percentage of CD4 +/IL2R + cells was 73%; the percentage of CD8 + / IL2R + was 11%. The ratio of CD4+/IL2R + cells: CD8+/IL2R + cells ranged from 4.0 to 14.0 (see table). Of five liver transplant recipients all treated with cyclosporine, the percentage of CD4 +/IL2R + cells was 59%. When patients were stable (i.e., no rejection episodes) the percentage o fCD8+/ IL2R + cells was 12%. The ratio of activated CD4 + :CD8 + cells was >_-3.4, as tested at several time points. At times of rejection, as evidenced histologically, the percentage of CD8 ÷ / IL2R + cells increased dramatically (37% vs. 12%). The ratio of activated CD4 + :CD8 + cells ranged from 1.1 to 2.5 during rejection. When patients were again stable, the percentage of activated CD8+/IL2R + ceils decreased, and the ratio of the two activated subsets returned to normal values. We believe this