Detection of antidonor antibody: advantages of fibroblast target cells.

Donor specific alloantibody was monitored in 40 kidney transplants for 3 most post-transplant. Two 51Cr release assays were used: complement-dependent lysis and antibody-dependent cell-mediated cytotoxicity. Fibroblast, lymphocyte, and lymphoblast target cells were all tested whenever possible. Antibody was detected in only 6 of 22 patients who achieved satisfactory function (creatinine less than 3 at 3 mos), but in 15 of 18 patients who had an unfavorable outcome (return to dialysis or creatinine greater than 3 at 3 mos). The association of antifibroblast antibody with poor function was particularly striking: in the 33 patients in whom donor fibroblasts were tested, none of 20 with good function had detectable antibody, whereas 10 of 16 with graft loss or poor function had detectable antibody. Studies with mouse fibroblasts indicated that the association of antifibroblast antibody with graft destruction may be explainable in terms of selective expression of various alloantigens on fibroblasts.