Induction of donor-specific immune modulation and successful renal transplantation with a simplified method of donor-specific blood transfusion Academic Article Article uri icon

Overview

MeSH Major

  • Cryopreservation
  • Kidney Diseases
  • Kidney Transplantation
  • Organ Preservation
  • Perfusion

abstract

  • We developed a new method of donor-specific blood transfusion (DST) for prospective kidney transplant recipients from a living related donor. Forty-four patients were transfused with 100 ml of one-haplotype matched kidney donor's whole blood at 1, 8, and 15 days after its storage. Ten of these patients received azathioprine (1.5 mg/kg per day) in addition to DST. After DST, three patients (6.8%) developed donor-specific lymphocytotoxic antibodies. The incidence of sensitization was not different between azathioprine-treated and untreated patients. Following DST, donor-specific mixed lymphocyte culture (MLC) was significantly suppressed without any accelerated (secondary type) response in early MLC. Subsequently, 24 patients received a kidney transplant from the donor. Graft survival rates were 96% and 90% at 12 and 24 months, respectively. Nine additional patients, seven from a two-haplotype matched sibling and two from a no-haplotype matched sibling also received DST. None of these patients became sensitized following DST, and all have functioning grafts for 6 to 18 months. This study indicates that 100 ml of stored whole blood DST three times at weekly intervals is a practical, less immunizing, and effective approach to enhance graft survival in recipients of a living related donor graft, DST produces donor-specific adaptive responses that might be conductive to successful graft outcome, and this protocol could be used in sibling donor-recipient pairs who do not share a haplotype.

publication date

  • January 1985

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.3109/08860228509104835

PubMed ID

  • 2940741

Additional Document Info

start page

  • 11

end page

  • 7

volume

  • 9

number

  • 1