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. 1980 Oct;192(4):543–552. doi: 10.1097/00000658-198010000-00012

Deliberate donor-specific blood transfusions prior to living related renal transplantation. A new approach.

O Salvatierra Jr, F Vincenti, W Amend, D Potter, Y Iwaki, G Opelz, P Terasaki, R Duca, K Cochrum, D Hanes, R J Stoney, N J Feduska
PMCID: PMC1347002  PMID: 6448588

Abstract

In order to select MLC incompatible one-haplotype related donor-recipient pairs that would achieve better graft survival and in an effort to alter the recipient immune response, 45 patients received three fresh blood transfuions from their prospective kidney donors. Recipient sensitization was evaluated by cross-match testing weekly sera obtained during and after the blood transfusions against donor T- and B-lymphocytes at 5 C (cold) and 37 C (warm). Thirteen (29%) of the 45 potential related recipients developed a positive warm T-cell cross-match or a persistent warm B-cell cross-match to their blood donor and related transplantation was not performed. Thirty-two (71%) patients had an appropriate negative cross-match to their blood donor. Thirty of these patients subsequently received kidneys from their blood donor. Ninety-seven per cent of the kidneys are functioning from one to 25 months with a single graft failure due to a patient discontinuing immunosuppressive medication. In addition to the excellent graft survival there was an unusually low incidence of rejection episodes in the recipients of kidneys from their blood donor so that the posttransplant course paralleled that of HLA-identical siblings. This approach may have future application with two-haplotype mismatched donor-recipient pairs, both related and unrelated.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cerilli J., Williams M. A., Newhouse Y. G., Fesperman D. P. Correlation of tissue typing, mixed lymphocyte culture, and related donor renal allograft survival. Transplantation. 1978 Oct;26(4):218–220. doi: 10.1097/00007890-197810000-00003. [DOI] [PubMed] [Google Scholar]
  2. Cicciarelli J. C., Chia D., Terasaki P. I., Barnett E. V., Shirahama S. IgM anti-IgM cold lymphocytotoxins to B cells. Transplant Proc. 1979 Dec;11(4):1950–1953. [PubMed] [Google Scholar]
  3. Cochrum K. C., Salvatierra O., Belzer F. O. Correlation between MLC stimulation and graft survival in living related and cadaver transplants. Ann Surg. 1974 Oct;180(4):617–622. doi: 10.1097/00000658-197410000-00027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fabre J. W., Morris P. J. The effect of donor strain blood pretreatment on renal allograft rejection in rats. Transplantation. 1972 Nov;14(5):608–617. doi: 10.1097/00007890-197211000-00013. [DOI] [PubMed] [Google Scholar]
  5. Feduska N. J., Vincenti F., Amend W. J., Jr, Duca R., Cochrum K., Salvatierra O., Jr Do blood transfusions enhance the possibility of a compatible transplant? Transplantation. 1979 Jan;27(1):35–38. doi: 10.1097/00007890-197901000-00009. [DOI] [PubMed] [Google Scholar]
  6. HALASZ N. A., ORLOFF M. J., HIROSE F. INCREASED SURVIVAL OF RENAL HOMOGRAFTS IN DOGS AFTER INJECTION OF GRAFT DONOR BLOOD. Transplantation. 1964 Jul;2:453–458. doi: 10.1097/00007890-196407000-00001. [DOI] [PubMed] [Google Scholar]
  7. Iwaki Y., Terasaki P. I., Park M. S., Billing R. Enhancement of human kidney allografts by cold B-lymphocyte cytotoxins. Lancet. 1978 Jun 10;1(8076):1228–1229. doi: 10.1016/s0140-6736(78)92464-9. [DOI] [PubMed] [Google Scholar]
  8. MERRELL M., SHULMAN L. E. Determination of prognosis in chronic disease, illustrated by systemic lupus erythematosus. J Chronic Dis. 1955 Jan;1(1):12–32. doi: 10.1016/0021-9681(55)90018-7. [DOI] [PubMed] [Google Scholar]
  9. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep. 1966 Mar;50(3):163–170. [PubMed] [Google Scholar]
  10. Marquet R. L., Heystek G. A., Tinbergen W. J. Specific inhibition of organ allograft rejection by donor blood. Transplant Proc. 1971 Mar;3(1):708–710. [PubMed] [Google Scholar]
  11. Newton W. T., Anderson C. B. Planned preimmunization of renal allograft recipients. Surgery. 1973 Sep;74(3):430–436. [PubMed] [Google Scholar]
  12. Opelz G., Terasaki P. I. Dominant effect of transfusions on kidney graft survival. Transplantation. 1980 Feb;29(2):153–158. doi: 10.1097/00007890-198002000-00013. [DOI] [PubMed] [Google Scholar]
  13. Opelz G., Terasaki P. I. Prolongation effect of blood transfusions on kidney graft survival. Transplantation. 1976 Oct;22(4):380–383. doi: 10.1097/00007890-197610000-00010. [DOI] [PubMed] [Google Scholar]
  14. Salvatierra O., Jr, Perkins H. A., Cochrum K. C., Duca R. M., Potter D. E., Amend W. J., Feduska N. J. HLA typing and primary cadaver graft survival. Transplant Proc. 1977 Mar;9(1):495–501. [PubMed] [Google Scholar]
  15. Salvatierra O., Jr, Potter D., Cochrum K. C., Amend W. J., Duca R., Sachs B. L., Johnson R. W., Belzer F. O. Improved patient survival in renal transplantation. Surgery. 1976 Feb;79(02):166–171. [PubMed] [Google Scholar]
  16. Soulillou J. P., Peyrat M. A., Guenel J. Association between treatment-resistant kidney-allograft rejection and post-transplant appearance of antibodies to donor B-lymphocyte alloantigens. Lancet. 1978 Feb 18;1(8060):354–356. doi: 10.1016/s0140-6736(78)91081-4. [DOI] [PubMed] [Google Scholar]
  17. Sutherland D. E., Lum C. T., Payne W. D., Najarian J. S. Effect of pretreatment with donor blood on renal allograft survival in dogs stratified by DLA match and MLC reactivity. Transplant Proc. 1979 Mar;11(1):160–166. [PubMed] [Google Scholar]
  18. Terasaki P. I., Bernoco D., Park M. S., Ozturk G., Iwaki Y. Microdroplet testing for HLA-A, -B, -C, and -D antigens. The Phillip Levine Award Lecture. Am J Clin Pathol. 1978 Feb;69(2):103–120. doi: 10.1093/ajcp/69.2.103. [DOI] [PubMed] [Google Scholar]
  19. Thomas J. M., Thomas F. T., Hoffman S., Johns C., Mendez-Picon G., Lee H. M. Donor-specific CML hyporesponsiveness after successful renal transplantation: studies on the mechanism. Transplant Proc. 1979 Jun;11(2):1258–1259. [PubMed] [Google Scholar]
  20. Uehling D. T., Hussey J. L., Belzer F. O., Kan C., Bach F. H. MLC incompatibility index for donor--recipient matching. Transplant Proc. 1977 Mar;9(1):103–105. [PubMed] [Google Scholar]
  21. Vincenti F., Duca R. M., Amend W., Perkins H. A., Cochrum K. C., Feduska N. J., Salvatierra O., Jr Immunologic factors determining survival of cadaver-kidney transplants. The effect of HLA serotyping, cytotoxic antibodies and blood transfusions on graft survival. N Engl J Med. 1978 Oct 12;299(15):793–798. doi: 10.1056/NEJM197810122991502. [DOI] [PubMed] [Google Scholar]
  22. van Rood J. J., Balner H. Blood transfusion and transplantation. Transplantation. 1978 Nov;26(5):275–276. doi: 10.1097/00007890-197811000-00001. [DOI] [PubMed] [Google Scholar]

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