Adoptive transfer of Hepatitis B immunity after kidney transplantation in the rat model

Background: Patients with endstage renal disease as well as kidney transplant recipients have a high risk of a quiring hepatitis B infection and the response rate to active vaccination is very low in these patients. Previous experiments have shown that donor immunity can be transferred to a transplant recipient via the organ graft. This study aims to explore the efficacy of adoptive transfer of immunity by kidney transplantation. Methods: Male ACI-rats were used as donors, male Lewis rats as kidney recipients. The donors were vaccinated -6 and -2 weeks prior to organ donation with recombinant Hepatitis B vaccine (Engerix(R)). The left kidney of the donor was removed and the kidney graft was transplanted in orthotopic position.. Half of the animals were treated with daily subcutanoeus injections of Cyclosporin in a dose of 5 mg/kg/day. Anti-Hbs titer in donor and recipient was measured weekly using a micro-particle enzyme-immuno assay (MEIA) (Abbott). Results: All recipients developed an anti-HBs titer of 28-144 IU/l, which corresponds to about 0.03-0.09% of the titer of the donor. The maximal titer was found at 1 week after transplantation and decreased continuously thereafter. Conclusion: Donor immunity can be transferrred after kidney transplantation to the same extent as after liver transplantation, although the number of passenger leucocytes is lower and the organ much smaller. Immunosuppressive treatment is not lowering the adoptive transfer of immunity. Possible clinical consequence of this finding is the mandatory vaccination of living kidney donors to prevent Hepatitis B-infection in kidney transplant recipients.