The current role of pre-transplant blood transfusions and tissue typing in cadaveric renal transplantation.
In a retrospective analysis of 74 consecutive cadaveric renal transplants performed at our center during a 38-month period we assessed the influence of random blood transfusions and tissue matching on graft and patient survival. All patients received cyclosporine and low dose prednisone with or without azathioprine as immunosuppressive therapy. Actual patient survival was 100 per cent at 1 year and actuarial 1-year graft survival was 82 per cent. Random blood transfusions and histocompatibility matching at the HLA-DR locus did not influence graft survival. Matching at 2 or more HLA-A and B loci was associated with a significant detrimental influence (p less than 0.05) on graft survival. We conclude that the use of cyclosporine-based immunosuppression overcomes much of the adverse effect of poor tissue matching and may obviate the need for random blood transfusions in cadaveric renal transplantation during the first year of engraftment.
Koyle
M A
MA
Department of Surgery/Urology, Harbor/UCLA Medical Center, UCLA School of Medicine, Torrance.
Rajfer
J
J
Mickey
M R
MR
Glassock
R J
RJ
Ward
H J
HJ
D001379:Azathioprine / Q000008:administration & dosage; D001803:Blood Transfusion; D002102:Cadaver; D003524:Cyclosporins / Q000008:administration & dosage; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens / Q000032:analysis; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery; D016030:Kidney Transplantation; D011241:Prednisone / Q000008:administration & dosage; D011300:Preoperative Care; D011897:Random Allocation; D012189:Retrospective Studies
D003524:Cyclosporins; D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D001379:Azathioprine; D011241:Prednisone