SEQUENTIAL MIXED LYMPHOCYTE CULTURE AFTER KIDNEY-TRANSPLANTATION - INDUCTION OF TOLERANCE OR SENSITIZATION

Serial mixed lymphocyte culture (MLC) was used to monitor the evolutio n of donor-specific responsiveness over the first 2 years after cadave ric renal transplantation. Lymphocytes obtained from 37 patients at 0, 1, 3, 6, 12, 18 and 24 months following transplantation were assayed in a one-way MLC using donor lymphocytes as stimulator cells. Donor-sp ecific hyporesponsiveness developed in 66% of the patients with functi oning grafts. Donor-specific sensitization was noted in 2 patients wit h functioning grafts and the MLC reactivity remained unchanged compare d to the pretransplant value in 8 patients. The patients with donor-sp ecific hyporeactivity tended to remain either free of rejection episod es or experienced early rejection episodes only. Thus, using serial ML C we were able to identify patients who developed hyporeactivity or to lerance to donor antigens. These patients may require less immunosuppr ession.