PMID- 2139985
OWN - NLM
STAT- MEDLINE
DCOM- 19900613
LR  - 20031114
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 49
IP  - 5
DP  - 1990 May
TI  - Hyperacute rejection in porcine liver transplantation. I. Clinical 
      characteristics, histopathology, and disappearance of donor-specific 
      lymphocytotoxic antibody from serum.
PG  - 861-8
AB  - Hyperacute rejection following orthotopic liver transplantation remains an 
      extremely unusual occurrence. In this study, we examined a porcine model of liver 
      transplantation in which recipient animals were sensitized prior to 
      transplantation with three serial full-thickness skin grafts. Three experimental 
      groups were studied. Group I recipients (n = 6) were specifically sensitized 
      against their liver donors with biweekly skin grafts followed by hepatic 
      grafting. Group II recipients (n = 6) underwent third-party skin graft 
      sensitization prior to liver transplantation. Group III recipients (n = 6) 
      underwent liver grafting without sensitization. Mixed lymphocyte cultures were 
      done before each skin graft and prior to transplantation. Lymphocytotoxic 
      antibody (LCTA) titers were measured before the first skin graft, at weekly 
      intervals thereafter, intraoperatively, and daily postoperatively until death. 
      Intraoperative and postmortem liver biopsies were obtained in all recipients. 
      Five of six recipients in Group I died within 4 hr of hepatic revascularization. 
      The remaining animal survived for four days. Mean survival time in group I was 0 
      +/- 0.7 days. In contrast, MST in groups II and III were 4.0 +/- 1.2 and 6.2 +/- 
      1.3 days, respectively. The MST in group I was significantly shorter than in 
      groups II and III (P less than 0.026 and P less than 0.005, respectively). There 
      was no significant difference in survival between groups II and III. MLC 
      reactivity between recipients and skin donors increased progressively following 
      each skin graft, reaching a peak just prior to liver transplantation. LCTA titers 
      also increased following each skin graft, reaching peak levels immediately prior 
      to hepatic grafting. Intraoperative LCTA titers decreased within 2 min of graft 
      revascularization and were undetectable within 4 hr. In group III (unsensitized 
      recipients), MLC reactivity was low and at no time was LCTA detectable. 
      Histologic examination of the livers from group I recipients showed parenchymal 
      hemorrhage, endophlebitis, and neutrophil infiltration. Histologic examination of 
      postmortem liver biopsies from animals in groups II and III revealed acute 
      cellular rejection. In conclusion, hyperacute rejection resulting in graft 
      failure and recipient death can be consistently produced in a porcine model of 
      hepatic transplantation by donor-specific sensitization of the recipient. It is 
      postulated that high titers of donor-specific antibody are required to exceed the 
      liver's capacity for antibody absorption and elimination and produce the clinical 
      picture of hyperacute rejection.
FAU - Merion, R M
AU  - Merion RM
AD  - Department of Surgery, University of Michigan Medical School, Ann Arbor 48109.
FAU - Colletti, L M
AU  - Colletti LM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Animals
MH  - Blood Pressure
MH  - Cytotoxicity, Immunologic
MH  - *Graft Rejection
MH  - Hydrogen-Ion Concentration
MH  - Isoantibodies/immunology
MH  - Liver Transplantation/*immunology/pathology
MH  - Lymphocyte Culture Test, Mixed
MH  - Lymphocytes/immunology
MH  - Swine
EDAT- 1990/05/01 00:00
MHDA- 1990/05/01 00:01
CRDT- 1990/05/01 00:00
PHST- 1990/05/01 00:00 [pubmed]
PHST- 1990/05/01 00:01 [medline]
PHST- 1990/05/01 00:00 [entrez]
PST - ppublish
SO  - Transplantation. 1990 May;49(5):861-8.