DEVELOPMENT OF ‘AUTO ANTI‐A1 ANTIBODIES’ FOLLOWING ALLOIMMUNIZATION IN AN A2 RECIPIENT

difference between the ‘antibody formers’ and ‘non-antibody formers’ appear to be the immunosuppressive regimens used post transplantation. All our patients who had developed these antibodies were on an immunosuppressive regimen of cyclosporine with or without prednisone, whilst the patients not forming antibodies, although transplanted with kidneys from group 0 donors, had received radiotherapy to the donor kidneys in addition to cyclosporine or Imuran. Antibody formation was most prominent when cyclosporine was used possibly because it selectively affects T-cell function and spares the B-cell activities (Britten & Palacios, 1982). Our retrospective analysis lent further support to this concept. In contrast, antibody formation was not seen when the donor kidney was irradiated. The donor lymphocytes acquired with the transplanted kidney may be destroyed by the irradiation. We therefore conclude that in renal transplant recipients with blood group A or B transplanted with kidneys from group 0 donors ‘auto’ antibody formation and haemolysis is a potential risk when irradiation is not given to the transplanted kidney. Furthermore, it is unlikely that the red cell antibodies are acquired by blood transfusion.