Mixed lymphocyte culture responses. Lack of correlation with cadaveric renal allograft survival and blood transfusions.

One-way and two-way mixed lymphocyte reactions (MLRs) between 65 cadaveric renal allograft recipients (R) and their specific-donor (D) and pooled third-party (P) cells were measured using a 5-day assay. There was no correlation between the results expressed as stimulation index, absolute counts, or the relative response and graft survival in transfused allograft recipients. Nontransfused recipients whose first graft failed had significantly higher responses to P, but not D, than those with successful grafts. The one-way MLRs to P of 61 cadaveric graft recipients and 52 potential recipients were measured. No correlation was found between the magnitude of the response and the number of transfusions, time since the last transfusion, or peak cytotoxic antibody production. Our results suggest that a standard 5-day MLR has little clinical value in predicting the results of cadaveric transplantation in HLA-A,B-mismatched recipient-donor pairs. We could not demonstrate any overall effect of transfusions on the MLR, suggesting that this may not be the mechanism by which transfusions exert their effect on graft survival.