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  • Title: Renal allograft recipient immunomodulation by concomitant immunosuppression and donor-specific transfusions.
    Author: Anderson CB, Jendrisak MD, Flye MW, Hanto DW, Anderman CK, Rodey GE, Sicard GA.
    Journal: Transplant Proc; 1988 Dec; 20(6):1074-8. PubMed ID: 3059589.
    Abstract:
    The induction of immunologic unresponsiveness to improve renal allograft survival was attempted in 151 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. Presensitization was present in ten patients and attempts at desensitization were uniformly unsuccessful. Of the 151 nonpresensitized patients, transient sensitization occurred in 3% and permanent sensitization in 7%. One hundred thirty-five of 140 nonsensitized patients underwent renal transplantation from the specific blood donor and 56% have never experienced a rejection episode. The allograft survival rate at 2 years (93%) and 7 years (87%) is significantly better (P less than .01) than our historical experience with one-haplotype living-related transplants at 2 years (68%) and 7 years (59%). 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 (2%) argue for a modification of the immunologic response, perhaps by clonal deletion, rather than a selecting-out process as the mechanism for improved allograft survival.
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