Use of the donor specific transfusion protocol in living-unrelated donor-recipient combinations.
The scarcity of suitable cadaver or living-related kidneys remains the major problem in renal transplantation. The use of the donor-specific transfusion protocol (DST) has allowed for the expansion of the donor pool to one- and two-haplotype mismatched living-related donor-recipient combinations. This study deals with the use of DST in living-unrelated donor-recipient combinations (LURD). The following 34 LURD combinations were entered: husband to wife; wife to husband; friend to friend; stepfather; brother-in-law and sister-in-law. Donor-specific sensitization occurred in 21%. Actuarial graft survival at 4 years is 92.6%, and patient survival is 100%. It is concluded that this study indicates that the results with the use of LURDs equal the results with living-related donors and, therefore, it is suggested that the use of LURDs can be considered in situations when a medically and ethically acceptable unrelated donor is available.
D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001803:Blood Transfusion; D002102:Cadaver; D006084:Graft Rejection / Q000187:drug effects; D006801:Humans; D016030:Kidney Transplantation; D012086:Reoperation; D014019:Tissue Donors / Q000523:psychology; D014181:Transplantation Immunology
D000961:Antilymphocyte Serum