Renal transplantation update.
Various factors affect the outcome of renal transplants in humans. Matching for HLA-A, -B, and -DR histocompatibility antigens improves survival rates for renal allografts from first cadaver donors. Zero-HLA-A- and -B-antigen-mismatched grafts and two-HLA-DR-antigen-matched grafts do better, although results differ depending on the recipient's primary renal disease. Pretransplant third-party blood transfusions significantly improve survival rates of cadaver donor allografts. The mechanism of this beneficial effect has not been identified; however, blood transfusions probably do not "select out" high responders among potential recipients by stimulating the production of lymphocytotoxic antibodies. Cyclosporine has been heralded as a potent, nonspecific immunosuppressive agent that will significantly improve renal allograft survival rates. The selectivity of cyclosporine's effect on T lymphocytes is advantageous; however, its side effects, especially nephrotoxicity, may limit its usefulness. Attention to the potential surgical complications of renal transplantation can significantly reduce morbidity and mortality.
D001803:Blood Transfusion; D002102:Cadaver; D003524:Cyclosporins / Q000009:adverse effects / Q000627:therapeutic use; D005832:Genital Diseases, Male / Q000209:etiology; D006650:Histocompatibility Testing; D006801:Humans; D007670:Kidney Calices; D007674:Kidney Diseases / Q000209:etiology; D016030:Kidney Transplantation; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D011183:Postoperative Complications; D011300:Preoperative Care; D012611:Scrotum; D014515:Ureteral Diseases / Q000209:etiology; D014517:Ureteral Obstruction / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000209:etiology; D014548:Urinary Fistula / Q000209:etiology; D014570:Urologic Diseases / Q000209:etiology; D014652:Vascular Diseases / Q000209:etiology
D003524:Cyclosporins