CULTURED KERATINOCYTE ALLOGRAFTS FAIL TO INDUCE SENSITIZATION IN-VIVO

Background The use of cultured keratinocyte (CK) allografts for burn w ounds offers a potentially unlimited supply of skin. It is unknown, ho wever, whether CK allografts induce rejection in vivo. This study inve stigated the induction of immune responsiveness to CK allografts as me asured by mixed lymphocyte response and serum cytotoxic antibody. Meth ods. Female CBA mice (n = 160) were randomized to four equal groups, e ach receiving a 3 cm2 flank graft of autologous CBA CK (Auto CK), allo geneic C57BL/6 CK (Allo CK), C57BL/6 full thickness skin (Allo FT), or Sham. Graft take was assessed by gross and histologic examinations. U nidirectional mixed lymphocyte response was measured with graft recipi ent and donor splenocytes by use of tritiated thymidine uptake. Stimul ation indexes were calculated. Serum cytotoxic antibody was measured b y coculturing graft recipient serum with donor splenocytes and rabbit complement and assessing resultant cell killing. Results. Overall graf t take was 50% for Allo CK and 74% for Auto CK. Allo FT, but not Allo CK, were associated with significantly increased stimulation indexes c ompared with Auto CK and Sham (p < 0.01). Allo FT, but not Allo CK, re sulted in elevated titers of alloantibody, reaching significant levels 10 days after grafting (p < 0.05). Conclusions. CK allografts do not result in increased in vitro T cell responses or enhanced alloantibody formation, indicating that sensitization to major histocompatibility antigens by CK does not occur. These data suggest that CK allografts m ay provide a possible source of grafts for victims of large burn wound s. (SURGERY 1993;114:416-22.)