Mixed lymphocyte culture, phytohemagglutinin stimulation, and matching grade: clinical relevance in renal transplantation from living related donors.

Mixed lymphocyte cultures (MLC), including phytohemagglutinin (PHA) stimulation and HLA-A and HLA-B loci typing of donor and recipient, were performed on 70 renal allograft recipients and relevant family members. Graft survival was correlated retrospectively with matchnd PHA response index (PHARI), in order to assess the clinical relevance of each variable singly or jointly. Overall graft survival was significantly associated with SI (log10) (P less than 0.001) and matching grade (P = 0.027). No significant association with either PHARI or II was detected (P greater than 0.10). In addition, the product of the last two indices--the lymphocyte response index (LRI)--was not found to be related to graft survival (P greater than 0.10). Survival of grafts with one-haplotype identity was significantly associated with SI (P = 0.002). Survival in this group was not found to be related to II, PHARI, or LRI, considered either alone or jointly (P greater than 0.10). Grafts with two-allele-identical grafts, whereas PHARI did not differ. SI and matching grade were related significantly to graft survival and appeared to be the most important variables.