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

Jhoong S. Cheigh, Manikkam Suthanthiran, Marilena Fotino, Matthew Kaplan, Monica Evelyn, Naomi Schechter, Carl F.W. Wolf, Robert R. Riggio, Robert Riehle, William T. Stubenbord, Kurt H. Stenzel, Albert L. Rubin

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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 (i) 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. (ii) DST produces donor-specific adaptive responses that might be conducive to successful graft outcome, and (iii) this protocol could be used in sibling donor-recipient pairs who do not share a haplotype.

Original languageEnglish
Pages (from-to)11-17
Number of pages7
JournalRenal Failure
Volume9
Issue number1
DOIs
Publication statusPublished - 1 Jan 1985
Externally publishedYes

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ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nephrology

Cite this

Cheigh, J. S., Suthanthiran, M., Fotino, M., Kaplan, M., Evelyn, M., Schechter, N., Wolf, C. F. W., Riggio, R. R., Riehle, R., Stubenbord, W. T., Stenzel, K. H., & Rubin, A. L. (1985). Induction of donor-specific immune modulation and successful renal transplantation with a simplified method of donor-specific blood transfusion. Renal Failure, 9(1), 11-17. https://doi.org/10.3109/08860228509104835