Abstract
In conclusion, of the six immunogenetic principles derived from cardiac allograft survival data in rodents, four predict the behavior of heart transplants in humans; transplantation across either MHC class I or class II disparities can result in acute cardiac allograft rejection, transplantation across MHC class II mismatches presents a stronger barrier to trans-plantation than class I mismatches, and the effects of multiple MHC disparities on cardiac allograft survival seem to be cumulative (principles 1, 2, 3, and 6). In addition, there is some evidence that the HLA-B locus products are more immunogenic than the HLA-A locus products (principle 4). 71 These findings support the concept of HLA matching in clinical heart transplantation 5,78 and the targeting of MHC class II-mediated immune responses with immunosuppressive agents to abrogate acute rejection. Recent work in partially inbred miniature swine suggest that MHC class I-mediated immune responses may play a more important role in chronic rejection. 25
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