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ID 32678
JaLCDOI
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Author
Sakagami, Kenichi
Shiozaki, Shigehiro
Fujiwara, Takuzo
Haisa, Minoru
Niguma, Takefumi
Kusaka, Satoshi
Uda, Masashi
Matsuno, Tsuyoshi
Takasu, Shinji
Yerdel, Mehmet Ali
Matsuoka, Junji
Tanaka, Shinichiro
Orita, Kunzo
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.

Keywords
living-related kindney transplantation
donor-specific blood transfusion (DST)
cyclosporine
Amo Type
Article
Published Date
1992-02
Publication Title
Acta Medica Okayama
Volume
volume46
Issue
issue1
Publisher
Okayama University Medical School
Start Page
1
End Page
5
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
File Version
publisher
Refereed
True
PubMed ID
Web of Science KeyUT