Renal transplantation from HLA-haploidentical living-related donors: the effects of donor-specific blood transfusions and different immunosuppressive regimens.

K. Sakagami, Shinya Saito, S. Shiozaki, Toshiyoshi Fujiwara, M. Haisa, T. Niguma, S. Kusaka, M. Uda, T. Matsuno, S. Takasu

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Abstract

One-hundred-nine HLA-haploidentical living related renal transplants have been retrospectively analysed to compare the effect of donor-specific blood transfusion (DST) and different immunosuppressive regimens on graft survival and acute rejection. The recipients were divided into four groups according to the immunosuppressive therapy. Group 1 (n = 44): conventional therapy with posttransplant azathioprine (AZP) + methylprednisolone (MP). Group 2 (n = 25): pretransplant DST + posttransplant AZP + MP. Group 3 (n = 12): triple-drug therapy with posttransplant AZP + MP + cyclosporine (CS). Group 4 (n = 25): pretransplant DST + posttransplant AZP + MP + CS. The five-year actuarial survival rates for groups 1, 2, 3 and 4 were 48%, 73%, 79%, and 89%, respectively. The graft survival rate in group 3 was significantly (p less than 0.01) better than that in group 1. The transfusion effect was reduced, and appears as a 10% improvement in the graft survival in the cyclosporin era compared with a 25% improvement at pre-cyclosporin era. Furthermore, the incidence of the first rejection episode was decreased in recipients that received DST. The present study revealed that DST, as pretransplant conditioning has a definite impact on rejection-free long-term graft survival in HLA-haploidentical living-related kidney recipients and the most favorable outcome in such patients could be achieved by DST pretreatment in conjunction with posttransplant triple-drug therapy including cyclosporine.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalActa Medica Okayama
Volume46
Issue number1
Publication statusPublished - Feb 1992

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Living Donors
Immunosuppressive Agents
Blood Transfusion
Kidney Transplantation
Blood
Cyclosporine
Methylprednisolone
Azathioprine
Tissue Donors
Graft Survival
Grafts
Drug therapy
Survival Rate
Kidney
Drug Therapy
Transplants
Incidence
Therapeutics

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Renal transplantation from HLA-haploidentical living-related donors : the effects of donor-specific blood transfusions and different immunosuppressive regimens. / Sakagami, K.; Saito, Shinya; Shiozaki, S.; Fujiwara, Toshiyoshi; Haisa, M.; Niguma, T.; Kusaka, S.; Uda, M.; Matsuno, T.; Takasu, S.

In: Acta Medica Okayama, Vol. 46, No. 1, 02.1992, p. 1-5.

Research output: Contribution to journalArticle

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