Failure of B-cold lymphocytotoxins to enhance cadaveric renal allograft survival.

In a three-year period between January 1980 and December 1982, 242 consecutive cadaver transplant recipients in one center were tested before transplantation by cytotoxicity against a random panel of T and B lymphocytes at 5 degrees C and 37 degrees C incubation. They were also tested for HLA-A, B, and DR antigens. Kidney transplants were carried out with the primary objective of achieving a two-DR match. Kidney transplants were carried out only in the absence of T-warm positive cross-matches. All patients were followed for a minimum period of one year after transplant. There have been no exclusions, and all causes of failure, including death, have been counted as graft losses. Patients were stratified according to HLA-A, B, and DR matches and were also divided into high-antibody and low-antibody groups. The recipients with no antibodies had the best one-year graft survival (66%). Recipients with B-cold antibodies did not have enhanced one-year graft survival (51%). Recipients with B-warm antibodies did indifferently (56%). The worst results were seen in recipients who had pretransplant T-warm antibodies (42%) though the number of patients in this group was small.