SEVENTEEN CONSECUTIVE SUCCESSFUL ONEHAPLOTYPE-MATCHED LIVING RELATED FIRST RENAL TRANSPLANTS USING DONORSPECIFIC BLOOD TRANSFUSIONS

Autor: MENDEZ, ROBERT, IWAKI, YUICHI, MENDEZ, RAFAEL, BOGAARD, THOMAS, VOLPICELLI, MARK, SELF, BARBARA
Zdroj: Transplantation; June 1982, Vol. 33 Issue: 6 p621-624, 4p
Abstrakt: A donor-specific transfusion (DST) protocol was carried out in 25 recipients obtaining kidneys from live-related one-haplotype-disparate high stimulating mixed lymphocyte culture (MLC) donors. The protocol consisted of the recipient receiving a transfusion of 200 ml of donor whole blood every 2 weeks for a total of three transfusions. Before and after each transfusion and just before transplantation, recipient blood samples were tested for cytotoxic antibody studies against a random panel of 30 normal persons, in addition to donor-recipient crossmatches. Patients were followed for a minimum of 8 months and a maximum of 24 months, with a mean followup of 14 months. Seventeen of 17 primary transplants performed were successful. Three second transplants were performed. Two second graft recipients rejected their transplants, while one was successful. Three patients of 25 developed either T-warm- or B-warm-positive crossmatches, while 2 patients who completed the study with negative crossmatches were not transplanted because of donor withdrawal following transfusions. Rejection episodes occurred infrequently, but when present, occurred early in the postoperative period (2nd or 3rd day). Only 6 of 25 subjects developed greater than 10 B-warm or T-warm circulating cytotoxic antibodies. Six of eight subjects who entered the study with greater than 10 cytotoxic antibodies had diminishment in the strength of their antibody response after the DSTs. No patient was rendered untransplantable by the development of large numbers of cytotoxic antibodies. DST appears to be a highly successful technique for primary living related donor transplants in subjects who are one haploid identical but with nonidentical stimulating MLC indices.
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