Successful transplantation of cyclosporine-treated haploidentical living-related renal recipients without blood transfusions.
A protocol of cyclosporine and prednisone immunosuppression was used in 36 consecutive haploidentical living-related renal transplant recipients from donors displaying marked proliferation in mixed lymphocyte culture (MLC) reactions. All blood transfusions (random third-party and donor-specific) were withheld once a negative crossmatch with the prospective kidney donor was obtained. With a mean follow-up of 13.6 months, patient survival is 97% (35/36) and graft survival is 92% (33/36). One graft was lost to rejection; two were abandoned because of sepsis. Only 14% (5/36) of patients experienced a rejection episode. No significant differences were evident in graft survival, rejection episodes, or renal function between the 15 recipients who were never transfused and the 21 with a history of previous blood transfusions. These findings suggest that pretransplant blood transfusions not only are unnecessary to achieve excellent graft survival, but also may jeopardize donor availability by donor-specific presensitization.
D000293:Adolescent; D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D014181:Transplantation Immunology
D003524:Cyclosporins; D006680:HLA Antigens; D000949:Histocompatibility Antigens Class II; D001379:Azathioprine; D011241:Prednisone