A controlled clinical trial of the immunosuppressive effect of extracorporeal irradiation of the blood in renal allotransplantation.
The immunosuppressive effect of extracorporeal irradiation of the blood (ECIB) in renal allotransplantation (RAT) has been investigated in a controlled clinical trial. A series of 101 uremic patients undergoing intermittent hemodialysis in preparation for RAT were allocated randomly to two groups; a treated group +ECIB (n=55), and a control group 0-ECIB (n= 46). ECIB treatment was given in the form of a fixed dose, with a transit dose of 400 rad and a cumulative dose of approximately 50 000 rad, both before and after RAT. A selective long-term lymphocytopenia was usually obtained, with no effect on immunoglobulins, complements or plasma proteins. Erythrocyte count was reduced in  the majority of cases, but this had no limiting effect on the implementation of treatment. The shortest survival times and most deaths occurred in the +ECIB group. The first rejection episode occurred later in the +ECIB group, but there was no difference between the groups in the number of rejections during the first two months or during the whole observation  period. There were more cases with two or more rejection episodes in the +ECIB than in the 0-ECIB group. There was no difference in graft survival, but shortest patient survival and most deaths after RAT occurred in the +ECIB group. It must therefore be concluded that the immunosuppressive effect of ECIB has no practical clinical relevance in RAT, and that ECIB given in the manner described involves the possibility of side-effects so serious that the method cannot be recommended.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D004905:Erythrocyte Aging / Q000528:radiation effects; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011830:Radiation Effects; D014184:Transplantation, Homologous