Background: The hand transplant consists of different tissues of varying immunogenetic potential. Donor's cells can contribute to either rejection or tolerance of the graft. The aim of our study was monitoring of anti-HLA antibodies, a mark of humoral rejection, and microchimerism (induction of donor specific tolerance?) in the first 3 months after transplantation.
Material/Methods: The recipient was 34 year old man with blood group A- positive; HLA-phenotype A24; B18, 60; DRB1*11. Multi organ cadaveric donor was 41 year-old man blood group A-positive; HLA-phenotype A 31,32; B 35, 39; DRB1*11,16, negative T- and B-cell cross-match. We examined recipient's blood and sera specimens, obtained 1 and 2 weeks, and 1, 2 and 3 months after transplantation. Anti-HLA antibodies were monitored by the complement-dependent cytotoxicity assay (CDC), with prolonged time of incubation, with PBL and B lymphocyte. Microchimerism was analyzed using nested polymerase chain reaction with sequence specific primers typing methods (nested
PCR-SSP) for detection of HLA-A alleles.
Results: No anti-HLA alloantibodies were detected in the study period, what
confirmes that humoral rejection occurs rarely, if at all, in the human composite tissue allografts. Peripheral microchimerism was observed in all tested specimens. It is still debated whether this microchimerism can induce tolerance or is it only a side effect of transplantation.

Keywords: composite tissue transplantation, Limb Transplantation