3.2
#70
PRESENCE OF ANTI LEWIS ANTIBODIES IN THE SERA OF TWO PATIENTS WITH CHRONIC REJECTION OF THE HEART.
Miyuki Ozawa , Paul I. Terasaki , Christine Tarsitani , Eric K. Ho and Nicole Suciu-Foca . Canoga Park CA, One Lambda, Inc. and New York NY, Columbia University, Department of Pathology .

---

Fourteen patients with transplant related coronary artery disease were examined for HLA antibodies. Twelve of the patients were shown to have HLA antibodies, consistent with the high association of HLA antibodies found earlier. However, 2 patients did not have HLA antibodies according to flow cytometry tests with soluble antigen coated beads. With cytotoxicity, which is a less sensitive test, the sera of these two patients were positive against a lymphocyte panel. The specificity of the antibody could not be determined since cells of various specificities reacted with the sera. When HLA antigen coated beads were tested with anti IgM, the sera continued to be negative. Since the sera reacted with T and more strongly with B lymphocytes, but not with purified HLA antigens, we hypothesized that the antibodies were against the Lewis antigen. Previous publications had shown that Lewis alloantibodies which are cytotoxic to lymphocytes are produced by pregnancies and transfusions.
Tests of the two sera against soluble Le a and Le b by ELISA tests were strongly positive. One other kidney transplant patient who had rejected a transplant was found to have a strong antibody to Lewis b, but not Lewis a.
The conclusion therefore is that aside from HLA antibodies being associated with chronic allograft rejection, antibodies to the Lewis system may also be responsible for some transplant patients. Extensive testing of other sera from rejected and rejecting patients are underway.