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The HL-A2 leucocyte antigen was found to be present in a significantly higher percentage of 485 patients with chronic glomerulonephritis than in 428 normal control subjects. No correlation could be shown between any of the ABO groups and chronic glomerulonephritis. There was no statistically significant difference in the frequency of HL-A2 when the controls were compared with 280 patients with a variety of other diseases. The trend toward an excess of HL-A2 positives among patients with glomerulonephritis was also seen in a study of 108 sibships, though the difference fell short of statistical significance. It was concluded that an HL-A2 positive person was about 1·5 times as likely to develop chronic glomerulonephritis as an HL-A2 negative person.

The shortage of cadaveric donor kidneys for transplantation has forced a re-evaluation of the limits on donor age acceptability. However, as more kidneys from older donors have been transplanted, a significantly lower graft survival has been noted among their recipients. The impact of utilizing older donor kidneys and the relative importance of donor age with respect to other factors has not been clarified. A total of 43,172 cadaver donor transplants reported to the UNOS Scientific Renal Transplant Registry between 1987 and 1995 were the subjects of this study. Cox regression analysis was utilized to assess the joint effects on graft survival of donor age and HLA mismatch, recipient sex, race, age, original disease, donor death cause, cold ischemia time, and transplant year. Increased first day anuria, dialysis requirement, and discharge serum creatinine were noted with increasing donor age. Moreover, long-term graft and patient survival diminished as donor age increased. The 5-yr graft survival of zero HLA-A,B,DR mismatched kidneys fell steadily from 81% when the donor was aged 21-30 to 39% when the donor was over age 60. The reported causes of kidney transplant failure were remarkably similar for old and young donors. The best transplant results were obtained with zero HLA-A,B,DR mismatched transplants from young donors and the worst with older donor kidneys, regardless of HLA compatibility. We calculated that up to 21% of kidney failures resulted from insufficient renal mass due to age and were incorrectly attributed to chronic rejection.

It has been said that heterologous antilymphocyte serum is highly specific in that (a) it lyses or agglutinates equally well the white cells from all members of the species which provided the immunizing lymphoid tissue3 and (b) that it does not react with the white cells from other species.1, 3, 4, 6 The fore-going concepts were based upon studies employing anterisera of relatively low titer. These questions have been re-examined with antidog- and antihuman-lymphoid globulin of high titer raised in horses with repeated subcutaneous immunization with lymph node, thymus, and spleen tissue.5 It has been found that the white cells of individuals within the species population, against which the anti-bodies were directed, were variably affected by the immune globulin. Furthermore, it has been shown that there is not an absolute species specificity inasmuch as some reactivity against the white cells of at least seven widely divergent species is present in either antidog- or antihuman-lymphoid globulin.