Skip to main content
Log in

Immunological transformations in the recipient of grafted allogeneic human bone

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Twenty-one patients received allogeneic human bone grafts following deep freezing according to various orthopaedic indications. The HLA antigens of all donors and recipients had been determined preoperatively, and grafting was performed without any respect to the HLA match. The immunological follow-up of the recipients was managed by two different methods: MLC (mixed lymphocyte culture) and MAILA (monoclonal antibody-specific immobilisation of lymphocyte antigens). No immunosuppression was performed. The follow-up lasted up to 6 years. Allogeneic grafting of human cancellous bone induces specific immunological reactions in the recipient. The consequences of these observations are: (1) allogeneic bone grafting may induce second-set reactions following subsequent blood transfusion, tissue grafting or organ transplantation; (2) transplantation of fresh, perfused, vascularised allogeneic bone or joint may become a therapeutic approach in the near future. Then the employment of standard immunosuppressive protocols will be mandatory in order to fight acute rejection of the graft.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Aebi M, Regazzoni P, Perren SM, Harder F (1986) Microsurgically revascularized bone allografts with immunosuppression with cyclosporine.

  2. Black WS, Hewitt CW, Fraser LA, Howard EB, Martin DC, Achauer BM, Furnas DW (1985) Composite tissue (limb) allograft in rats. Tansplantation 39:365–368

    Google Scholar 

  3. Burchardt H (1983) The biology of bone graft repair. Clin Orthop 174:28–42

    Google Scholar 

  4. Burchardt H, Glowczewskie FP, Enneking WF (1977) Allogeneic segmental fibular transplants in azathioprine-immunosuppressed dogs. J Bone Joint Surg [Am] 59:881–894

    Google Scholar 

  5. Burwell RG (1963) Studies in the transplantation of bone. V. The capacity of fresh and treated homografts of bone to evoke transplantation immunity. J Bone Joint Surg [Br] 45:386–401

    Google Scholar 

  6. Burwell RG, Gowland G (1961) Studies in the transplantation of bone. II. The changes occurring in the lymphoid tissue after homografts and autograft of fresh cancellous bone. J Bone Joint Surg [Br] 43:820–843

    Google Scholar 

  7. Centers for Disease Control (ed) (1988) Transmission of HIV through bone transplantation: case report and public health recommendations. Morb Mort Wkly Rep. 37:597

  8. Clohisy DR, Mankin HJ (1994) Osteoarticular allografts for reconstruction after resection of a musculoskeletal tumor of the proximal end of the tibia. J Bone Joint Surg [Am] 76:549–554

    Google Scholar 

  9. Doi K, Santis G, Singer DJ, Hurley JV, O'Brien B, McDay SM, Hickey MJ, Murphy BF (1989) The effect of immunosuppression on vascularized allografts. J Bone Joint Surg [Br] 71:576–582

    Google Scholar 

  10. Doppelt SH, Tomford WW, Lucas AD, Mankin HJ (1981) Operational and financial aspects of a hospital bone bank. J Bone Joint Surg [Am] 63:1472–1481

    Google Scholar 

  11. Friedlaender GE, Mankin HJ (1979) Guidelines for the banking of musculoskeletal tissues. Am Assoc Tissue Banks Newsl 3:2–4

    Google Scholar 

  12. Friedlaender GE, Strong DM, Sell KW (1976) Studies on the antigenicity of bone. J Bone Joint Surg [Am] 58:854–858

    Google Scholar 

  13. Friedlaender GE, Strong DM, Sell KW (1984) Studies on the antigenicity of bone. II. Donor-specific anti-HLA-antibodies in human recipients of freeze-dried allografts. J Bone Joint Surg [Am] 66:107–112

    Google Scholar 

  14. Hofmann GO (1991) Immunologischer und hygienischer Stellenwert der allogenen Knochentransplantation für die Wiederherstellungschirurgie. Akt Chir 26:126–133

    Google Scholar 

  15. Hofmann GO (1992) Allogene Knochentransplantation. In: Bünte H, Junginger T (eds) Jahrbuch der Chirurgie. Biermann, Zülpich, pp 131–142

    Google Scholar 

  16. Hofmann GO, Kirschner MH (1995) Allogeneic vascularized transplantation of human femoral diaphysis under cyclosporin A immunosuppression. Transplant Int 8:418–419

    Google Scholar 

  17. Hofmann GO, Kirschner MH; Wangemann T, Falk C, Mempel W, Hammer C (1995) Infections and immunological hazards of allogeneic bone transplantation. Arch Orthop Trauma Surg 114:159–166

    Google Scholar 

  18. Innis PC, Randolph MA, Paskert JP, Burdick JF, Clow LW, Yaremchuk MJ, Weiland AJ (1991) Vascularized bone allograft: in vitro assessment of cell-mediated and humoral responses. Plast Reconstr Surg 87:315–325

    Google Scholar 

  19. Kuner EH, Keller H (1986) Knochenbank. Orthopäde 15:16–21

    Google Scholar 

  20. Langer F, Czitrom A, Pritzker KPH, Gross AE (1975) The immunogenicity of fresh and frozen allogeneic bone. J Bone Joint Surg [Am] 57:216–220

    Google Scholar 

  21. Mankin HJ, Doppelt S, Tomford W (1983) Clinical experience with allograft implantation. Clin Orthop 174:69–86

    Google Scholar 

  22. Mempel W (1972) Die gemischte Lymphozytenkultur in der immunologischen Spenderauswahl. Klin Wochenschr 50:287–295

    Google Scholar 

  23. Mueller-Eckhardt C, Kiefel V, Santoso S (1989) Recent trends in platelet antigen/antibody detection. Blut 59:35–113

    Google Scholar 

  24. Mueller-Eckhardt G, Kiefel V, Schmidt A, Tlusty A, Santoso S, Mueller-Eckhardt C (1989) Discrimination of antibodies against antigens of different MHC loci in human sera by monoclonal antibody-specific immobilization of leukocyte antigens. Hum Immunol 25:125–134

    Google Scholar 

  25. Mueller-Eckhardt G, Kiefel V, Tlusty A, Scholten J, Schmidt A, Mueller-Eckhardt C (1990) Incidence and specificity of HLA-DP antibodies in pregnancy sera. Hum Immunol 29:166–174

    Google Scholar 

  26. Müller ME, Allgöwer M, Schneider R, Willenegger H (1991) Manual of internal fixation, 3rd edn. Springer, Berlin Heidelberg New York

    Google Scholar 

  27. Muscolo DL, Kawai S, Ray RD (1976) Cellular and humoral immune response analysis of bone- allografted rats. J Bone Joint Surg [Am] 58:826–832

    Google Scholar 

  28. Popkirov S, Minev M (1976) Die klinische Bedeutung der immunologischen Befunde bei der Transplantation von Alloknochen. Arch Orthop Unfall Chir 85:289–298

    Google Scholar 

  29. Rosso R, Schdfer D, Fricker R, Schldpfer R, Brennwald J, Heberer M (1993) Vascularized knee joint transplantation in a canine model: early results after allografting and autografting. In: Becker HM et al (eds) Chir. Forum 1993. Springer, Berlin Heidelberg New York, pp 363–367

    Google Scholar 

  30. Schratt HE, Spyra JL, Ascherl R, Lechner F, Blümel G (1988) Zur Antigenität von kältekonserviertem Knochen — experimentelle und klinische Untersuchungen. In: Schriefers KH et al Chir. Forum 1988. Springer, Berlin Heidelberg New York, pp 131–136

    Google Scholar 

  31. Siliski JM, Simpkin S, Green CJ (1984) Vascularized whole knee joint allografts in rabbits immunosuppressed with cyclosporin A. Arch Orthop Trauma Surg 103:26–35

    Google Scholar 

  32. Simonds RJ, Holmberg SD, Hurwitz RL, Coleman TR, Bottenfield S, Conley LJ, Kohlenberg SH, Castro KG, Duhan BA, Schable CA, Rayfield MA, Rogers MF (1992) Transmission of human immunodeficiency virus type 1 from a seronegative organ and tissue donor. N Engl J Med 326:726–732

    Google Scholar 

  33. Terasaki PI, McCelland JD (1964) Microdroplet assay of human serum cytotoxins. Nature 204:998–1000

    Google Scholar 

  34. Urovitz EP, Czitrom AA, Langer F, Gross AE, Pritzker PH (1976) Immunogenicity of virus-induced rat ostesoarcoma. J Bone Joint Surg [Am] 58:308–311

    Google Scholar 

  35. Vander Griend RA (1994) The effect of internal fixation on the healing of large allografts. J Bone Joint Surg [Am] 76:657–663

    Google Scholar 

  36. Wellmitz G (1975) Biologische Wertigkeit von homostatisch konservierten Knochenimplantaten und Regenerationsleistungen des Organismus. Beitr Orthop Traumatol 22:699–700

    Google Scholar 

  37. Wissenschaftlicher Beirat der Bundesärztekammer (1990) Richtlinien zum Führen einer Knochenbank. Dtsch Artzeblatt 87:1341–1344

    Google Scholar 

  38. Yaremchuk MJ, Sedacca T, Schiller AL, May JW (1983) Vascular knee allograft transplantation in a rabbit model. Plast Reconstr Surg 71:461–472

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

The project ‘Human Bone Transplantation’ is supported by the Karl -Wilder-Stiftung Munich, a grant of the German Life Insurances.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hofmann, G.O., Falk, C. & Wangemann, T. Immunological transformations in the recipient of grafted allogeneic human bone. Arch Orthop Trauma Surg 116, 143–150 (1997). https://doi.org/10.1007/BF00426063

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00426063

Keywords

Navigation