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

J. S. Cheigh, Manikkam Suthanthiran, M. Fotino, M. Kaplan, M. Evelyn, N. Schechter, C. F. Wolf, R. R. Riggio, R. Riehle, W. T. Stubenbord

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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
JournalUremia Investigation
Volume9
Issue number1
Publication statusPublished - 1 Dec 1985
Externally publishedYes

ASJC Scopus subject areas

  • Nephrology

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    Cheigh, J. S., Suthanthiran, M., Fotino, M., Kaplan, M., Evelyn, M., Schechter, N., Wolf, C. F., Riggio, R. R., Riehle, R., & Stubenbord, W. T. (1985). Induction of donor-specific immune modulation and successful renal transplantation with a simplified method of donor-specific blood transfusion. Uremia Investigation, 9(1), 11-17.