[Immunological aspect of the patients receiving TDD pretreatment MLR and MLR suppressor activity].

Thoracic duct drainage (TDD) given to prospective kidney transplant patients has resulted in a significant improvement in the graft survival rate. Thirty-six patients receiving TDD pretreatment got a kidney transplanted from HLA one-haploidentical living related donors. The graft survival was 100% after 1 and 2 years, confirming the superiority of TDD conditioning over the previous results with non pretreatment HLA one-haploidentical kidney transplanted patients. To investigate the mechanism of this beneficial effect, we have analysed immune response in the patients receiving TDD pretreatment. Peripheral blood mononuclear (MN) cells were obtained before and every 10 days during TDD pretreatment and were tested for ability to respond against donor cells in MLR and to suppress MLR of third party. Stimulation index (RDx/RRx) was 7.3+6.7 before TDD, 3. 0+2. 9 (p<0. 025)10 days after TDD, 2. 4+1. 7 (p<0. 005) 20 days and 2. 9+2. 6 (p<0. 005) 30 days. The value of MLR-suppression was -33+23% in the patients prior to TDD pretreatment and -37+29% in control patients maintained by H. D. In proportion to the duration of TDD, especially 20 days after TDD, MLR suppression gradually increased (r=0. 77, p<0. 001). In conclusion, our data suggest that TDD pretreatment yields a hyporesponsiveness against the donor allo-antigens and the hyporesponsiveness might be partially induced by suppressor cells.

[1]  M. Mathew,et al.  Donor-specific suppressor cells and donor-specific loss of cell-mediated lympholysis in renal allograft recipients: a comparative study. , 1984, Transplantation proceedings.

[2]  P. Redlich,et al.  Evaluation of lymphocyte subsets and suppressor cell function in long-term renal transplant recipients. , 1984, Transplantation proceedings.

[3]  G. Coles,et al.  Blood transfusions, suppressor T cells, and renal transplant survival. , 1983, Transplantation.

[4]  P. Lang,et al.  EXPRESSION OF OKT 8 ANTIGEN AND Fcγ RECEPTORS BY SUPPRESSOR CELLS MEDIATING SPECIFIC UNRESPONSIVENESS BETWEEN RECIPIENT AND DONOR IN RENAL‐ALLOGRAFT-TOLERANT PATIENTS , 1983, Transplantation.

[5]  K. Orita,et al.  Evidence for donor-specific cell-mediated lympholysis unresponsiveness and suppressor cells in well functioning kidney transplants. , 1983, Transplantation proceedings.

[6]  G. Agostino,et al.  SUPPRESSION OF MIXED LEUKOCYTE CULTURE USING LEUKOCYTES FROM NORMAL INDIVIDUALS, UREMIC PATIENTS, AND ALLOGRAFT RECIPIENTS , 1982, Transplantation.

[7]  J. Dausset,et al.  Probable role of suppressor cells and factors in kidney graft survival. , 1982, Transplantation proceedings.

[8]  H. Grosse-wilde,et al.  Characterization of transfusion-induced suppressor cells in prospective kidney allograft recipients. , 1982, Transplantation proceedings.

[9]  P. Lang,et al.  SPECIFIC RECIPIENT‐DONOR UNRESPONSIVENESS MEDIATED BY A SUPPRESSOR CELL SYSTEM IN HUMAN KIDNEY ALLOGRAFT TOLERANCE , 1982, Transplantation.

[10]  G. Klintmalm,et al.  Late follow-up after thoracic duct drainage in cadaveric renal transplantation. , 1981, Surgery, gynecology & obstetrics.

[11]  G. Klintmalm,et al.  Determinants of effectiveness of thoracic duct drainage for primary cadaver kidney transplantation. , 1981, Transplantation proceedings.

[12]  G. Coles,et al.  The effect of blood transfusion on T-suppressor cells in renal dialysis patients. , 1981, Transplantation proceedings.

[13]  A. Kluge,et al.  Blood transfusion-induced suppression of cellular immunity in man. , 1980, Human immunology.

[14]  T. Starzl,et al.  Thoracic Duct Fistula and Renal Transplantation , 1979, Annals of surgery.

[15]  J. Thomas,et al.  Macrophage-related suppressor cells in human renal transplant recipients. , 1979, Surgery.

[16]  T. Kovithavongs,et al.  Suppressor cells and loss of in vitro killer cell inductiveness to donor cells in the peripheral blood lymphocytes of allograft recipients. , 1979, Transplantation proceedings.

[17]  T. Kovithavongs,et al.  Evidence for suppressor cells and reduced CML induction by the donor in transplant patients. , 1978, Transplantation proceedings.

[18]  J. Dubernard,et al.  Thoracic duct drainage and antilymphocyte globulin for renal transplantation in man. , 1978, Kidney international. Supplement.

[19]  O. Ringdén,et al.  DRAINAGE OF THORACIC DUCT LYMPH IN RENAL TRANSPLANT PATIENTS , 1976, Transplantation.

[20]  G. Beathard,et al.  Depletion of lymphocytes for the protection of renal allografts. , 1970, Archives of internal medicine.

[21]  J. Murray,et al.  Chronic Thoracic Duct Fistula: Operative Technic and Physiologic Effects in Man , 1968, Annals of surgery.

[22]  J. Gowans,et al.  THE ANTIBODY RESPONSE OF RATS DEPLETED OF LYMPHOCYTES BY CHRONIC DRAINAGE FROM THE THORACIC DUCT , 1963, The Journal of experimental medicine.

[23]  I. Mackay,et al.  Suppressor cells in stable dialysis and transplant patients. , 1982, Nephron.

[24]  T. Starzl,et al.  DR-bearing T lymphocytes in thoracic duct lymph. , 1981, Clinical immunology and immunopathology.

[25]  J. Murray,et al.  The immunosuppressive effect of thoracic duct drainage in human kidney transplantation. , 1970, Annals of internal medicine.

[26]  P. Medawar,et al.  The induction of tolerance by skin homografts on newborn rats. , 1958, Immunology.