Transplantation

Organ transplantation has almost disappeared from headlines in the daily press, possibly because it failed to fulfill exaggerated expectations. Transplanta tion pathology has become more and more important, not only with relation to therapeutic transplantations but even more in its fundamental theories. There is some analogy here to the development in space science where spectacular achievements were followed by sobering frustrations and where, for the time being, the effect on technology is more fruitful than the outcome of the original far-reaching projects. That transplant rejection was defined, in most of its stages, as an immunologic process, has given many new impulses to immunology in general. Transplantation assays have become a pet experiment in immunobiology and an abundant source of general information and knowledge. The implications of such a development could not be predicted when the present volume was outlined and planned. In accordance with the concept of WILLI MASSHOFF, general transplantion pathology was given a central position as a fundamental science, while the chapters on the transplantation of various tissues are of a more paradigmatic character. It was MASSHOFF who invited competent authors and who managed to balance their articles, despite some overlapping, so as to draw a comprehensive picture of contemporary transplanta tion pathology. WILLI MASSHOFF died while he was editing the first manuscripts. As co-editors we have undertaken to complete the publication that we began together.

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With contributions by numerous experts

Inhalt
The Main Histocompatibility System in Man.- A. Introduction.- B. Historical Background.- C. Methodology and Serological Considerations.- I. Leukoagglutination.- II. Lymphocyte Cytotoxicity.- III. Platelet Complement Fixation.- IV. Serum Sources.- 1. Polytransfused Patients.- 2. Pregnancy.- 3. Immunization of Human Volunteers.- 4. After Organ Transplantation.- 5. Natural Lymphocytotoxins.- 6. Immunization of Animals.- D. Genetics of the HL-A System.- E. Heterogeneity and Cross-Reactivity of HL-A Antigens.- F. HL-A, Mixed Lymphocyte Culture (MLC), Cell-Mediated Lympholysis (CML), and Cellular Immunity.- G. HL-A System and Clinical Transplantation.- I. Skin Graft Survival.- II. Kidney Transplantation.- III. Variability in the Host Immune Response.- IV. Donor Selection for Kidney Transplantation.- V. Bone Marrow Transplantation.- H. HL-A System and Human Diseases.- I. HL-A and Hematologic Malignant Diseases.- II. HL-A and Cancer (other than Lymphomas).- III. HL-A and Immunopathic Diseases.- IV. HL-A and Infectious Diseases.- V. HL-A and Rheumatoid Diseases.- VI. HL-A System and Various other Diseases.- I. HL-A System and Blood Transfusion.- J. HL-A System and Disputed Paternity Cases.- K. Conclusions.- References.- Gene Products of the Major Histocompatibility Complex: Biology and Chemistry.- 1. Introduction.- 2. The MHC in Man and Animals.- 2.1 Similarities.- 2.2 Differences.- 3. Biology of Human MHC Products.- 3.1 HL A Antigens.- 3.2 ß2-Microglobulin (ß2m).- 3.3 Ir-Region in Man.- 3.4 Association of HL A with Disease.- 4. Additional Information from Animal Studies.- 4.1 Genetics of the H-2 Complex.- 4.2 I-Region Traits and Functions.- 4.3 Donor Specific Prolongation of Transplant Survival.- 5. Chemistry of Human and Mouse MHC Gene Products.- 5.1 Homology.- 5.2Membranes and Models.- 5.3 Methods.- 5.4 Biochemistry of HL A/H-2 Antigens.- 5.5 ß-Microglobulin.- 5.6 Immune Response Region Associated Antigens (Ia).- 6. Concluding Remarks.- References.- LymphocyteDefined Components of the Major Histocompatibility Complex.- A. Introduction. General Principles of MLC.- B. Technical and Statistical Aspects of Human MLC.- I. Macro- and Micro-Methods.- II. Determination of Non-Stimulation.- 1. Controls.- 2. Statistical Analysis.- 3. Quantitation of MLC Results.- C. Mouse MLC Techniques.- D. Genetics of MLC in Humans.- I. Basic Principles.- II. Correlation of MLC Non-Stimulation in Siblings with Inheritance of the Same HL-A Haplotype.- III. Exceptional Cases of Stimulation and Non-Stimulation.- IV. Association of Stimulation with Four-Locus Region.- V. Minor loci.- VI. MLC and HL-A Typing in Unrelateds.- E. Genetics of MLC in the Mouse.- F. MLC Typing.- I. Principle of TypingUse of Homozygous Cells.- II. Problems in Defining a Typing Response.- G. Cell-Mediated Lympholysis (CML) Reaction.- I. CML in the Human.- II. CML in the Mouse.- III. Relation of CML and MLC.- H. Correlations of MLC with Grafting.- I. Conclusion.- Appendix I. Statistical Definitions.- Appendix II. Definition of Genetic Terms.- Addendum.- References.- Phylogenetic Aspects of Transplantation.- A. Introduction.- B. Transplantation Reactions in Invertebrates Other than Annelids and Echinoderms.- 1. Organelle Transplantation in Protozoans (Sarcodina, Ciliata).- 2. MetazoansSpecificity of Reaggregation in Porifera.- 3. Incompatibility in Cnidaria (Hydrozoa, Anthozoa).- 4. Platyhelminthes and Sipunculida.- 5. Equivocal Incompatibilities in Mollusca (Pelecypoda, Gastropoda, Cephalopoda).- 6. Arthropoda.- 7. Genetic Control in Urochordata.- 8. Summary of QuasiImmunorecognition.- C. Transplantation Reactions in Invertebrates that Reveal Primordial Cell-Mediated Immunity.- I. Short-term Immunologic Memory.- II. Cell and Tissue Responses that Indicate Self Recognition in Echinoderms.- III. Transplantation in Asteroidea.- IV. Short-term Memory.- V. The Earthworm Model.- 1. First- and Second-Set Allograft Rejection in Lumbricus terrestris and Eisenia foetida.- 2. Rejection of First- and Second-Set Xenografts Exchanged between Lumbricus and Eisenia.- 3. Specificity and Anamnesis.- 4. The Cellular Response.- 5. The Role of Temperature in Earthworm Tissue Graft Rejection.- 6. Summary.- D. Transplantation Immunity in Fishes.- I. Introduction.- II. The Hagfish.- III. The Lamprey.- IV. Cartilaginous Fishes.- V. Bony Fishes (Holosteans; Teleosts).- E. Transplantation Immunity in Amphibians.- I. Adult Apodans.- 1. Introduction.- 2. General Description of Autografts and Allografts.- 3. Histopathology.- II. Adult Urodeles.- 1. The Latent Phase.- 2. The Rejection Phase.- 3. The Chronic Rejection Response to Xenografts.- 4. Role of the Thymus in Graft Rejection.- 5. Histologic Differences in Skin.- 6. Suppression of Transplantation Immunity.- III. Anurans.- 1. Larvae.- 2. Bone Marrow Restoration of Transplantation Immunity in Adult Leopard Frogs.- F. Transplantation Immunity in Reptiles.- I. Introduction.- II. The Chronic Response in Turtles.- III. The Importance of Temperature in Turtles.- IV. The Mexican Iguana.- V. The Garter Snake.- References.- Ontogenetic Aspects.- A. Introduction.- B. Ontogeny of Lymphoid Structures.- C. Ontogeny of Transplantation Immunity.- D. Ontogeny of Thymus-Dependent Functions.- E. Concluding Remarks.- References.- Humoral and Cell-Mediated Mechanisms of Allograft Rejection.- A. Introduction.- B. Assay Methodsof Cell-Mediated Cytotoxicity (CMC).- C. Cytotoxicity Mediated by Specifically Sensitized T-Cells.- D. In Vivo Formation of Cytotoxic T Lymphocytes.- E. In Vitro Formation of Cytotoxic T Lymphocytes.- F. Mechanism of T-Cell Cytotoxicity.- G. Specificity of Target Cell Destruction by Cytotoxic T Lymphocytes.- H. Antibody-Dependent Cytotoxicity Mediated by Normal Lymphoid Cells.- I. Cytotoxicity Mediated by Macrophages.- K. Relevance of CMC to Allograft Rejection.- L. The Role of Antibody in Allograft Rejection.- References.- Cell Systems Participating in Graft Rejections.- A. Introduction.- B. Lymphocytes.- I. Development of the Immune System and Lymphocyte Subclasses.- 1. Early Ontogenesis of Lymphoid Organs and Cells.- 2. Postnatal Development of the Lymphocytic Systems.- 3. The Central Role of the Thymus.- II. Peripheral Lymphocytes.- 1. Lymphocyte Subclasses.- a) T Cells.- b) B-cells.- c) Null Cells.- 2. The Functions of Peripheral Lymphocytes.- a) Helper and Suppressor Activity.- b) Cell-Mediat…