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The mixed lymphocyte culture when carried out in two stages (discriminative mixed lymphocyte culture—DMLC) can differentiate between cytotoxic vs. blocking antibody. We have employed the DMLC to predict by an in vitro assay at what point a state of in vivo enhancement had occurred. Dogs undergoing unmodified rejection of heterotopic renal allografts rejected their kidneys in five to nine days. Following rejection cytotoxic antibody could be detected both by microlymphocytotoxicity testing and by nonreversible blocking of the DMLC assay. The DMLC predicted the presence of cytotoxic antibody weeks after the microlymphocytotoxicity assay was no longer positive. Transplants from the donor of the first kidney, if carried out during this time interval, were rejected in less than six days. Approximately two months following transplantation the DMLC assay became reversible. Kidney transplants from the original donor performed during this time interval were not rejected before ten days. Column chromatography isolated an active immunoglobulin component responsible for the in vitro blocking in the IgG fraction. A means of prospectively predicting in vivo enhancement may be at hand.
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☆Supported by National Institutes of Health Grant No. CA 14459-01.
☆☆Presented at the Thirty-fourth Annual Meeting of the Society of University Surgeons, New Orleans, La., Feb. 8–10, 1973.
© 1973 Published by Elsevier Inc.