[Intrafamilial renal transplantation in children after donor blood transfusions].
This article represents an update of our experience with deliberate donor specific blood transfusions (D.S.T.) prior to living-related renal transplantation in children. Eighteen recipients with a negative cross- match to donor T and B cells entered the D.S.T. protocol without regard to the results of the mixed lymphocyte cultures and third party transfusion. The D.S.T. procedure involves the administration of fresh packed cells on 2 or 3 separate occasions at 4 weeks intervals. The potential recipient's sensitization is closely monitored against donor's isolated T and B lymphocytes and against a random panel. This immunological monitoring is done 10 to 20 days after each D.S.T. and just prior to grafting. A negative T and B cross-match at 37 degrees C is a pre-requisite for transplantation. Sixteen patients have been transplanted. All kidneys are functioning with follow-ups ranging from 6 to 48 months; 10 patients have normal renal function, 2 of them experienced reversible acute rejection and 6 have chronic rejection. The benefits derived from pretransplant D.S.T. in parental renal transplantation appear to be substantial, although the nature of the various immunological mechanisms remains unclear.
Kaplan
C
C
Niaudet
P
P
Gagnadoux
M F
MF
Bacri
J L
JL
Reznikoff
M F
MF
Muller
J Y
JY
Broyer
M
M
D000293:Adolescent; D001803:Blood Transfusion / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005190:Family; D006082:Graft Enhancement, Immunologic; D006801:Humans; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D011446:Prospective Studies; D013997:Time Factors
Transplantation rénale intrafamiliale chez l'enfant après transfusions du sang du donneur.