Effect of donor-specific transfusions on the outcome of renal allografts in the cyclosporine era
- 1 January 2006
- journal article
- Published by Frontiers Media SA in Transplant International
- Vol. 19 (1), 19-26
- https://doi.org/10.1111/j.1432-2277.2005.00233.x
Abstract
Despite the introduction of new immunosuppressive agents, a steady decline of functioning renal allografts after living donation is observed. Thus nonpharmacological strategies to prevent graft loss have to be reconsidered, including donor-specific transfusions (DST). We introduced a cyclosporine-based DST protocol for renal allograft recipients from living-related/unrelated donation. From 1993 to 2003, 200 ml of whole blood, or the respective mononuclear cells from the potential living donor were administered twice to all of our 61 recipient candidates. The transplanted subjects were compared with three groups of patients without DST from the Collaborative Transplant Study (Heidelberg, Germany) during a 6-year period. Six patients were sensitized without delay for a subsequent cadaveric kidney. DST patients had less often treatment for rejection and graft survival was superior compared with subjects from the other Swiss transplant centers (n = 513) or from Western Europe (n = 7024). To diminish the probability that superior results reflect patient selection rather than effects of DST, a 'matched-pair' analysis controlling for relevant factors of transplant outcome was performed. Again, this analysis indicated that recipients with DST had better outcome. Thus, our observation suggests that DST improve the outcome of living kidney transplants even when modern immunosuppressive drugs are prescribedKeywords
This publication has 22 references indexed in Scilit:
- Mechanisms of Tolerance Induced by Donor-Specific Transfusion and ICOS-B7h Blockade in a Model of CD4+ T-Cell-Mediated Allograft RejectionAmerican Journal of Transplantation, 2005
- Mechanism of Action of Donor-Specific Transfusion in Inducing ToleranceJournal of the American Society of Nephrology, 2004
- Donor Antigen and Transplant Tolerance StrategiesJournal of the American Society of Nephrology, 2004
- Pretransplant blood transfusions revisited: a role for CD4+ regulatory T cells?1Transplantation, 2004
- Prophylactic deoxyspergualin treatment in living-related renal-transplant recipients transfused with donor-specific bloodTransplantation, 2003
- Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomesTransplantation, 2002
- The beneficial effect of donor-specific transfusions: a review of existing explanations and a new hypothesis based on a relatively unapplied theory of T cell immunoregulation. A regulatory hypothesis in progress…Medical Hypotheses, 2000
- EVALUATION OF PRE- AND POSTTRANSPLANT DONOR-SPECIFIC TRANSFUSION/CYCLOSPORINE A IN NON-HLA IDENTICAL LIVING DONOR KIDNEY TRANSPLANT RECIPIENTSTransplantation, 1999
- Donor-specific blood transfusion in living-related renal transplantation: Fourteen-year experienceTransplantation Proceedings, 1997
- Deliberate Donor-specific Blood Transfusions Prior to Living Related Renal TransplantationAnnals of Surgery, 1980