Association of anti-Fab and anti-IgG antibodies with high kidney transplant survival.

Pretransplant sera from 371 first cadaver and 58 second cadaver kidney transplant patients were examined for the presence of anti-Fab and antiimmunoglobulin antibodies. The 1-year graft survival rate for 109 patients with anti-Fab antibodies was 59 +/- 5% as compared with 47 +/- 5% for 106 patients without anti-Fab antibodies (p less than 0.05). Among patients with more than five transfusions, those with anti-Fab antibodies had a survival rate of 81 +/- 8% as compared with 53 +/- 9% for patients with no anti-Fab antibodies (p less than 0.01). Among 74 patients with anti-IgG antibodies, the 1-year graft survival rate was 63 +/- 6% as compared with 56 +/- 3% for 270 patients without anti-IgG antibodies (p = N.S.). After more than five transfusions, the graft survival rate was 83 +/- 1% for those with anti-IgG and 68 +/- 6% for those without IgG (p = N.S.). There was no correlation between the presence of anti-Fab and anti-IgG antibody and the number of transfusions. We conclude that anti-Fab antibodies and possibly anti-IgG antibodies have an enhancing effect on graft survival.