Anti-HLA immunisation in 130 haemodialysed patients.

Anti-HLA immunisation has been studied in 130 patients treated by haemodialysis between 1969 and 1978. Until 1977 blood transfusions were restricted (number of transfusions per patient averaged 3.42 units). However 50% of the patients were found to be immunised. The frequency of immunisation was higher in women patients (63%) than in men (39.7%). This difference shows a good correlation with the frequency of pregnancies (r = 0.849). The percentage of immunisation increases in parallel with the number of months of dialysis (r = 0.95). The capacity to eliminate HBS Ag seems to be related to the capacity for anti-HLA immunisation: 64% of the patients transiently positive for HBS antigen develop anti-HLA antibodies and only 26.7% when antigenaemia is persistent. Since 1977, 24 patients have been transfused with two units of whole blood once a week for three weeks, every six months. Antibodies appeared in only seven of them who had been transfused some years ago. The GLA system and transplantation play a small part. The age and the type of nephropathy seem to have no effect. A few patients developed antibodies for no apparent reason. Possibly bacterial or viral infections, or venous allografts were responsible.