Regional organ procurement (ROP) trays in renal allograft distribution and outcome.

ROP trays containing patient serum samples and distributed by the South-Eastern Organ Procurement Foundation (SEOPF) were instituted to increase the likelihood of transplanting potential renal recipients who are highly sensitized to HLA antigens. This study examines kidney distribution and transplant outcome to assess equitable placement and clinical function post transplant with and without the use of ROP trays. Data were collected over a 26-month period on the distribution of kidneys from 328 consecutive SEOPF donors from whom at least 1 kidney was procured.

Immunogenetic factors that may contribute to ethnic differences in renal allograft survival.

In the United States, allocation of cadaveric kidneys is federally regulated and based on the concept of equal access to all patients, regardless of race, sex, age, or socioeconomic status. Nevertheless, it has been widely reported that African American patients with renal disease wait longer for kidney transplantation and, once transplanted, have poorer graft survival. We have assessed immunogenetic factors that may contribute to ethnic differences in allograft survival by examining the distributions of ABO blood groups, HLA antigens and haplotypes, percent reactive antibody (PRA), age, and gender in our local patient population.

Repeated HLA mismatches and second renal graft survival in centers of the South-Eastern Organ Procurement Foundation.

To determine if repeated HLA mismatches and other putative risk factors were predictive of second graft failure in second grafts performed at Southeastern Organ Procurement Foundation (SEOPF) members centers, we identified a cohort of 753 retransplants in which one or more HLA antigens were mismatched in primary grafts. Of this group, 158 (21.1%) received second grafts with repeated mismatches of one or more HLA-A, B, or DR antigens that were previously mismatched in the primary graft (RMMs).

Lymphocytotoxicity crossmatch proficiency testing among regional transplant centers.

During an eight and a half-year period (1976-1984), 408 combinations of different cells and sera involving 12,652 lymphocytotoxicity crossmatch reactions performed by 21-37 histocompatibility laboratories were studied in 20 proficiency tests conducted by the South-Eastern Organ Procurement Foundation. Consensus by 75% or more laboratories were obtained on 336 (82.4%) of these test samples: of the 10,410 reactions examined with the use of these consensus cells and sera, only 649 (6.

Reduced graft rejection with good HLA-A and B matching in high-risk corneal transplantation.

We examined the effect of matching for HLA-A and B antigens on the success of corneal transplantation in a single-center, prospective, masked study that began in March 1979. The study involved 97 consecutive recipients at high risk because of prior corneal graft rejection or serious vascularization of the native cornea. Donor corneas were selected on the basis of ABO-blood-group compatibility, a negative lymphocyte crossmatch, and optimal HLA-A and B matching; all clinical personnel were "masked" to the degree of HLA matching during the study.

A randomized study comparing leukocyte-depleted versus packed red cell transfusions in prospective cadaver renal allograft recipients.

A prospective randomized study at a single renal transplant center between 1980 and 1982 compared the influence of leukocyte-depleted versus packed red cell pretransplantation blood transfusions on patient sensitization to leukocyte (HLA) antigens, likelihood of receiving a graft, and eventual transplantation results. All consenting potential cadaver renal transplant recipients (n = 107) were randomly assigned to receive transfusions at 6-week intervals with either packed red cells (Group 1) or leukocyte-poor red cells (Group 2) until they were transplanted. Actuarial graft and patient survival were identical for graft recipients in both groups.

The effect of parental HLA compatibility on the expression of paternal haplotypes in offspring.

The compatibility of HLA-A,-B expression between mother and offspring was examined in 410 families serologically tissue typed within a single transplant lab from 1972 thru 1982. The study group included 410 mothers of 1719 children (range 2-13/mother), with 352 one-father and 58 multiple-father families There were seven cases of monozygous twins and seven cases each of maternal and paternal allelic recombination. The degree of haplotype matching between the oldest offspring and subsequent siblings was within the expected range of distribution.

Immunobiology of primary intracranial tumors. Part 8: Serological responses to active immunization of patients with anaplastic gliomas.

Serial serological studies were carried out on 19 of 20 patients with malignant gliomas who were actively immunized with one of two human glioma tissue culture cell lines (D-54MG or U-251MG). Most patients mounted a significant serum reaction to histocompatibility antigens (HLA's), as well as an antibody response to fetal bovine serum (FBS) which was added to the glioma-cell inoculum. These two sources of antibody accounted for greater than 90% of the antibody induced by these inoculations.

Histocompatibility testing for keratoplasty in high-risk patients.

Forty-eight consecutive patients at high risk for corneal graft rejection were transplanted with corneas from donors selected on the basis of a negative lymphocyte crossmatch, ABO blood group compatibility, and maximized HLA-A, -B matching. Graft survival in this study group was compared to a retrospective control group of 72 consecutive high-risk transplants performed in patients receiving randomly obtained corneal donors. Demographic parameters, cause of primary disease, and incidence of prior graft rejection were no different between the two groups.

Familial predisposition to filarial infection--not linked to HLA-A or-B locus specificities.

Two hundred and twenty-five Polynesians were selected from a larger study population for the evaluation of potential genetic influences on the susceptibility to bancroftian filariasis. Analysis showed that there was significantly familial clustering of patients with filariasis and that this clustering was most compatible with genetic transmission of disease susceptibility. The data best fit a model in which the hypothetical gene for filariasis was recessive with a frequency of 0.

Segregation of three recently identified HLA specificities in an American Black family.

Three recently identified HLA specificities have been detected in a ten-member American Black family using 8th International Histocompatibility Testing Workshop and local antisera. Independent segregation of the two principal components of 8w59 (Bu and SV) was demonstrated. An Aw19-related specificity also segregated in the family.

Problems arising from the use of the HLA system in paternity testing.

Characterization of the HLA antigens present on lymphocytes has become an important procedure in paternity testing. This paper presents data on two cases in which the HLA antigens exhibited by the mother, child and alleged father were consistent with paternity but where the other genetic markers clearly showed exclusion of paternity. The use of HLA data alone to calculate probability of paternity in these two cases produced misleading figures.

HLA histocompatibility antigens in a Polynesian population -- Cook islanders of Mauke.

Polynesians living on the island of Mauke in the Cook Island group were typed for HLA-A and -B locus antigens. The Mauke population has restricted HLA polymorphism, with five A-locus antigens and four B-locus antigens accounting for a majority of the HLA phenotypes. Although some differences in antigen frequency were found when Mauke Islanders were compared with Polynesians from Easter Island and Samoa, the Mauke Islanders were closer in their HLA antigenic profile to polynesians than to Melanesians.

Colorimetric microdetermination of plasma lactate.

A simple ten-minute colorimetric procedure for plasma lactate is described. Good agreement with an ultraviolet procedure indicates acceptable accuracy. Precision, recovery, and interference studies further substantiate this procedure's validity.

Factors which have a significant effect on the survival of human skin grafts.

Survival of 436 ABO-compatible skin grafts exchanged in 97 Caucasian families was prolonged if donor and recipient were genotypically, as compared with phenotypically, HLA identical. Among skin grafts between haploidentical family members, a mismatch at the A locus was equivalent to a mismatch at the B locus. Skin grafted from child to mother survived longer than did skin grafted between other family members, other variables being equivalent.

New substrate for fluorometric determination of gamma-glutamyltransferase activity in serum.

We describe the preparation of a new substrate, N-gamma-L-glutamyl-5-aminoisophthalic acid dimethyl ester hydro-chloride, for the fluorometric determination of gamma-glutamyltransferase activity in serum by the "front-surface" technique. Details of the resulting method are provided. The final reaction mixture contains 4 mmol of the substrate per liter of tris(hydroxymethyl)aminomethane (100 mmol/liter) and glycylglycine (75 mmol/liter) at pH 8.