The clinical significance of anti-B-cell antibodies in kidney and pancreas
transplantation remains unresolved. Here, we report an isolated hyperacute
rejection of the kidney, but not the pancreas, during a simultaneous kidney
-pancreas (SKP) transplant. The hyperacute rejection was due to IgG antibod
ies directed against class II antigens expressed on B-cells.
Antibodies directed against class II antigens are generally not thought to
produce hyperacute rejection, since class II antigens allegedly are minimal
ly expressed on vascular endothelium in the kidney. The pancreas was spared
and continues to function normally, suggesting that class II antigens were
not strongly expressed in this pancreas. The differential susceptibility t
o B-cell antibodies of the two transplanted organs is noteworthy and should
call attention to the danger from IgG antibodies to class II antigens in k
idney transplantation.