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January 22, 1973

Medical News

JAMA. 1973;223(4):375-384. doi:10.1001/jama.1973.03220040003002

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Studies of rejection mechanism start to pay off—slowly  Presensitization remains a serious drawback to successful transplantation of visceral organs. The term applies to a condition wherein graft recipients have preformed cytotoxic circulating antibodies or lymphocytes that are presensitized to the graft antigens; this can lead to either hyperacute or acute rejection.Presensitized lymphocytes, according to Felix T. Rapaport, MD, professor of surgery at New York University School of Medicine, may develop in two ways. The first is as a result of prior tissue damage, as seen in patients with nephritis who may even lose transplants from twins due to recurrence of the disease.The second way is through staphylococcal or streptococcal infections. Dr. Rapaport and colleagues have shown that bacterial membranes (such as those of group A streptococci) and mammalian membranes share certain glycoprotein antigens. Thus activated lymphocytes—or antibodies against the bacterial antigens—may participate in the accelerated rejection of a graft that possesses