Beneficial effects of donor-specific transfusions on long-term renal allograft function.
The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 163 patients by the pretransplant administration of donor-specific whole blood or buffy coat in conjunction with continuous Aza immunosuppression. All donor-recipient combinations were at least one-haplotype disparate, and 21 were two-haplotype disparate. Transient sensitization occurred in 2% and permanent sensitization in 7%. Over a 10-year period, the DST+Aza allograft survival rate is similar to the HLA-identical sibling transplants. The CMV sepsis rate was only 2%, and there were no lymphoproliferative neoplasms. The low rate of sensitization (7%) has permitted almost all patients to undergo eventual renal transplantation from the specific blood donor. This and the low rate of early rejection (3%) argues for a modification of the immunologic response.
Anderson
C B
CB
Washington University School of Medicine, St. Louis, MO 63110.
Brennan
D
D
Keller
C
C
Goss
J
J
Shenoy
S
S
Burton
K
K
Sicard
G
G
Flye
M W
MW
D001379:Azathioprine / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology; D001787:Blood Group Incompatibility; D001803:Blood Transfusion; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology* / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D007114:Immunization; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D009679:Nuclear Family; D011183:Postoperative Complications / Q000453:epidemiology; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous
D001379:Azathioprine