Tissue typing and immunological aspects of organ transplantation

Abstract

Although transplantation of tissues is very artificial biologically, therapeutically it has provided a successful approach to management of functional failure of a variety of organs or systems. It has long been recognised that successful blood transfusion is dependant on matching the blood groups of donor and recipient red cells. In his Nobel lecture of 1931 Landsteiner suggested that similar "blood groups" would be involved in the acceptance or rejection of other transplanted tissues. By the end of the 1940's both Simonsen and Dempster had confirmed the early rejection of allografted dogs kidneys noted previously by Carrell and Guthrie and drew attention to the massive intrarenal infiltration of lymphoid cells which accompanied progressive renal failure. These observations and ideas developed still further in 1953 by Mitchison and Gowans led to the realisation that although cell mediated immunity was mainly responsible for acute rejection in the first few days after transplantation, humeral mechanisms and cytotoxic antibodies were also involved in the host response to allografts [Excerpt].