Endothelial antibodies in renal transplantation.

Sera of 97 consecutive transplant recipients were studied for the presence of antibodies directed against their renal allografts. A highly significant correlation (p less than 0.001) was found between irreversible rejection and donor-specific endothelial antibodies (EAb). EAb reacted not only with the endothelium of peritubular capillaries and venules, but also with glomeruli. Absorption of EAb to platelets, B- or T-lymphocytes did not remove its EAb activity or its cytotoxicity for monocytes. Furthermore, it was shown with a panel of randomly chosen donor kidneys, that EAb are directed against a polymorphic system of endothelial-monocyte antigens, which is unrelated to HLA-A, -B, -C or -D.