Renal allograft histopathology in dog leukocyte antigen mismatched dogs after renal transplantation.
OBJECTIVE
To evaluate allograft histopathology in dog leukocyte antigen (DLA)-mismatched dogs undergoing renal transplantation, with transient immunosuppression.


METHODS
Prospective study.


METHODS
Ten healthy adult mongrel dogs.


METHODS
Reciprocal renal transplantation and bilateral nephrectomy were performed. Immune conditioning consisted of nonmyeloablative (200 cGy), total body irradiation (TBI), bone marrow transplantation (BMT; 7 dogs), cyclosporine (CSA; 15 mg/kg every 12 hours), mycophenolate mofetil (MMF; 10 mg/kg every 12 hours) and intermittent prednisone (1 mg/kg every 12-24 hours). Biopsies were collected at transplantation, during full immunosuppression (44-90 days), and once medications were reduced or discontinued (228-580 days). Biopsies were evaluated for interstitial, tubular, vascular, and glomerular lesions. Blood urea nitrogen, creatinine, serum CSA concentrations, and clinical score were determined at each biopsy.


RESULTS
Seven dogs survived >200 days (mean, 380 days). Transient CSA toxicity was suspected in 6 dogs. Lymphocytic, plasmacytic interstitial inflammation, and tubulitis progressed when immunosuppressive medications were decreased. All 7 dogs had histologic lesions consistent with some degree of allograft rejection at study end.


CONCLUSIONS
Nonmyeloablative TBI, BMT, and short-term immunosuppression with CSA, MMF, and prednisone allowed renal allograft function and dog survival for >200 days. It appears unlikely that total drug withdrawal will be possible in unrelated DLA-mismatched dogs using this protocol.


CONCLUSIONS
Transient immunosuppression with MMF, CSA, and prednisone along with BMT and nonmyeloablative TBI may make kidney transplantation a clinical reality for treatment of kidney failure in dogs. Initiating both MMF and CSA at lower dosages may potentially eliminate early renal allograft injury.
Broaddus
Kristyn D
KD
Department of Clinical Sciences and Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL 36849, USA.
Tillson
D Michael
DM
Lenz
Stephen D
SD
Niemeyer
Glenn P
GP
Brawner
William R
WR
Welch
Janet A
JA
Lothrop
Clinton D
CD
D000818:Animals; D016026:Bone Marrow Transplantation / Q000276:immunology / Q000662:veterinary; D004285:Dogs / Q000601:surgery*; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000473:pathology / Q000662:veterinary*; D006085:Graft Survival; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D006650:Histocompatibility Testing / Q000662:veterinary; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology / Q000662:veterinary*; D008297:Male; D009392:Nephrectomy / Q000662:veterinary; D011446:Prospective Studies; D023001:Transplantation Tolerance; D014184:Transplantation, Homologous / Q000662:veterinary; D016896:Treatment Outcome
D015395:Histocompatibility Antigens Class I; D007166:Immunosuppressive Agents; C039692:histocompatibility antigen DLA