Attempted enhancement in patients undergoing renal allotransplantation: lack of long-term sensitization.

It seems timely and pertinent to review the long-term follow-up of four patients who were deliberately exposed before transplant to donor antigens in an "enhancement" protocol. Not only were there no adverse effects observed, but three of the four patients never had an identifiable rejection episode. One of the successful allograft recipients had cytotoxic antibodies to his donor's cells. These appear to have been cold, T- and B-cell-reactive antibodies of doubtful significance. Both long-term surviving recipients showed weakness in degree of mitogenesis in mixed culture of donor and recipient peripheral blood mononuclear cells, which does not appear to be related to a macrophage defect but may be related to a lack of active rosette-forming T cells.