Sollinger H W, Burlingham W J, Sparks E M, Glass N R, Belzer F O
Transplantation. 1984 Dec;38(6):612-5. doi: 10.1097/00007890-198412000-00013.
The donor-specific transfusion protocol (DST) with (DST+I) or without Imuran has resulted in improved graft survival in one-haplotype-mismatched high-MLC-reactive donor-recipient combinations. In this study we have extended the use of donor-specific transfusions to unrelated individuals (group 1), distant relatives (group 2), and two-haplotype-mismatched siblings (group 3). All grafts in group 1 and group 2 are functioning. In group 3, one patient was lost from a myocardial infarct and one kidney was lost due to rejection. In vitro testing was performed using cryopreserved cells obtained prior to transfusion (t0), after the third transfusion (tt), and after transplantation (tx). We observed patient-specific suppression in tt plasma and nonspecific suppression by tx plasma. We also found ADCC-like activity in tx, but not in t0 or tt plasma in 2 out of 3 patients. The suppressor effect of tt plasma is mediated by IgG antibody and possibly reflects an antiidiotypic antibody.
采用（DST+I）或不采用硫唑嘌呤的供者特异性输血方案（DST）已使单倍型不相配且高混合淋巴细胞反应性的供者-受者组合中的移植物存活率提高。在本研究中，我们将供者特异性输血的应用扩展至无关个体（第1组）、远亲（第2组）以及双单倍型不相配的同胞（第3组）。第1组和第2组中的所有移植物均功能良好。在第3组中，1例患者因心肌梗死死亡，1例肾脏因排斥反应丧失。使用输血前（t0）、第三次输血后（tt）以及移植后（tx）获取的冻存细胞进行体外检测。我们在tt血浆中观察到患者特异性抑制，在tx血浆中观察到非特异性抑制。我们还在3例患者中的2例tx血浆中发现了类似抗体依赖细胞介导的细胞毒性（ADCC）的活性，但在t0或tt血浆中未发现。tt血浆的抑制作用由IgG抗体介导，可能反映了一种抗独特型抗体。
