Transplantation and humanism in the new millenium.
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Biomedical subjects
Publications and source records attributed to J Dausset.
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HLA-G is a non-classical major histocompatibility complex class I molecule that differs from the classical HLA-A, -B and -C molecules by (i) alternative splicing of mRNAs encoding for at least four membrane-bound and two soluble HLA-G isoforms, (ii) a limited polymorphism, and (iii) a tissue-restricted distribution. Studies over the past few years have elucidated the function of HLA-G demonstrating inhibition of both NK cell- and T cell-mediated cytolysis. Furthermore, aside from its expression during pregnancy, we have shown that HLA-G is also expressed in solid tumor cells (i.e. human melanoma cell lines and ex vivo melanoma biopsies). Here we present a review of the current state of knowledge of the immunotolerant functions of HLA-G and their implications in materno-fetal tolerance and tumor immunosurveillance.
The functions of the genes included in the HLA complex have been studied mainly through the allogenic response, in vitro and in vivo. The sequence of this response was established thanks to primary and secondary MLC and CML. It appears that at least two clones of T lymphocytes are involved, the first in the non-self recognition through HLA-D differences, and the second in immunization against the HLA-A and B incompatibilities. Many associations between HLA and diseases have been found. They can be classified in three categories according to their associations with HLA-B, D, or with another gene of the complex. They are true experiments of nature which will give clues to the physiological functions of the HLA complex genes.
The RITRAN program is applied to renal transplantation and operates within the framework of France Transplant. It makes it possible to choose the most compatible kidney recipient within the ABO blood group system and within the major histocompatibility system in man (HLA). The file presently comprises the data stored on tape concerning 1800 dialysis patients who are awaiting grafts. It is managed by UNIVAC 1108 computer. More than 25 medical-surgical transplant teams from France, Switzerland, Holland and Spain are connected with the computer. It was five years ago that the first interrogation system began operating in real time 20 hours out of 24, using a telex line, and it continues to provide complete satisfaction. The updating of the data is done by the RITREC system, also using a telex machine. An adaptation of the programs applied for choosing blood and platelet donors is in the process of being realized.
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