James C. Pierce

Transamidinase activities, in vitro, of tissues from various mammals and from rats fed protein-free, creatine-supplemented and normal diets☆

Spleen, skeletal muscle, heart muscle, lung, brain, and testes from various mammals have been found to have measurable amounts of transamidinase activities, in vitro. These activities, expressed per unit weight of tissue, were only a fraction of the activities found in kidney and pancreas. However, in the rat, for example, the sum of the calculated total tissue activities of spleen, muscle, lung, brain, and testes was similar to the sum of the calculated total tissue activities of kidney and pancreas. Rats were fed normal, creatine-supplemented, and protein-free diets, and it was found that kidney and pancreas were the only tissues from the rats fed the latter two diets that had below normal activities. The possibility that there may be a significant synthesis of guanidinoacetic acid, in vivo, in tissues other than kidney and pancreas is discussed.

Technical considerations in the transplantation of the kidney to the dog's neck*

Summary A technique for transplantation of the kidney to the dogs neck employing end-to-end suture of therenal vessels to the common carotid artery and external jugular vein with a cutaneous ureterostomy is described. The technical considerations necessary for the prevention of hydronephrosis and pyelonephritis have been emphasized.

Relevance of HL-A Antigens to Acute Humoral Rejection of Multiple Renal Allotransplants

Abstract Acute humoral (hyperacute) rejection occurred in 3.3 per cent of 153 first renal allotransplants and in 35 per cent of 31 second, third and fourth transplants. To test whether or not immunization by previous transplants to HL-A antigens distributed at two subloci could account for this striking increase in the frequency of immunization, the Immunization Index was calculated for donor recipient combinations of various relatedness, races and numbers of transplants. The figure of 11 cases of acute humoral rejections in 31 multiple transplants correlated well with 12.2 cases predicted by the model, and there was similar close agreement for several subgroups. Immunization to the HL-A system of histocompatibility antigens is probably sufficient to account for the percentage of acute humoral rejections observed in recipients of multiple renal allotransplants without the involvement of a third HL-A sublocus or other histocompatibility loci.

A mixed antiglobulin test with kidney cells in suspension for IgG antibody in human allograft recipients.

A modification of the mixed antiglobulin test for the detection of IgG antibodies directed against human kidney cells has been devised which uses a suspension of individual kidney cells rather than a monolayer culture as antigen so that it may be employed clinically as a prospective crossmateh for organ transplantation. The anti-globulin reagent is added to the sensitized kidney cells rather than to the indicator erythrocytes, which reduces the background of nonspecific reations almost to zero. It is reproducible. The mixed antiglobulin test detected antibody in the sera of patients on chronic dialysis two to four times more frequently than did either the immune adherence test or the most sensitive modification of the microlymphocytotoxicity test which was utilized. It detected the development of antibody specific for donor kidney cells in the sera of 5 of 10 allograft receipients during periods of good to moderate renal transplant function several months before rejection.

Humoral antibody responses following transplantation in man.

Sequential titers of five different humoral antibodies (antirat erythrocyte, antisheep erythrocyte, isoantibodies, rheumatoid factors, and serum agglutinators) were simultaneously performed on 20 patients with renal transplants, 12 patients with skin transplants, and 2 patient populations (one hospitalized and one ambulatory). The results suggested that rises in titer of any of these antibodies could not be used as an indicator of acute rejection. Nevertheless, patients who lacked rejection episodes were unlikely to show humoral responses and always lacked antiglobulin responses. Heterophil responses always preceded antiglobulin responses. These results suggest that heterophils are cross reacting antibodies and antiglobulins are auxiliary immune responses.

A mixed antiglobulin test for the detection of immunoglobulin G antibody to lymphocytes.

SUMMARY A mixed antiglobulin test with lymphocytes as test antigens has been developed for the detection of IgG antibodies. Free lymphocytes were counted before and after the addition of anti-D-coated indicator erythrocytes to quantitate the test. The optimal ratio of lymphocytes to indicator erythrocytes was 1: 30. Both anti-T and anti-B lymphocyte antibodies were detected by the test. Nonspecific agglutination of B lymphocytes and detector erythrocytes was avoided by the use of an appropriate dilution of the goat anti-human y chain reagent. Unlike cytotoxicity tests it could be used with dead lymohocytes that were frozen and stored intact as well as with live lymphocytes. Lymphocytes were better test antigens than were kidney cells from the same donors in the test. The mixed antiglobulin test with lymphocytes was also more sensitive in the detection of antibodies in hemodialysis patients than was the microlymphocytotoxicity test.