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A total of 78 consecutive HLA nonidentical living related donor transplant recipients with moderate to high stimulating mixed lymphocyte culture indexes underwent a deliberate donor-specific blood transfusion protocol. Of the patients 67 were first and 11 were second allograft recipients. Patients were monitored for immunological responses by cytotoxic B-cold, B-warm and T-warm antibody responses to a random panel of 30 donors, and by serial crossmatches to their donor subset B and T lymphocytes at 5C and 37C before beginning the protocol and after each donor-specific blood transfusion. Patients were followed from 3 months to 2 1/2 years, with allograft survival rates reported by the actuarial method. Survival rates of first allograft recipients were 96.0 plus or minus 2.77, 93.97 plus or minus 3.37, 93.97 plus or minus 3.37 and 90.68 plus or minus 4.50 per cent at 3 and 6 months, and 1 and 2 years, respectively. Of the patients entering the protocol for a primary transplant 20.18 per cent had persistently positive crossmatches. With increasing numbers of previous random blood transfusions a statistically significant sensitization rate was noted. Patient sensitization showed a general pattern of initial development of B-warm lymphocytotoxins resulting in positive B-warm crossmatches, which progressed to T-warm lymphocytotoxins and positive T-warm crossmatches if donor-specific blood transfusions continued. However, on development of B-warm positive crossmatches reversion to a negative crossmatch with successful transplantation was possible upon cessation of transfusions. No patient in the study was rendered nontransplantable due to donor-specific blood transfusions. All 5 patients who were completely disparate suffered amnestic type rejection episodes but following control of the rejection the course mimicked that of mixed lymphocyte culture identical living related donor transplants. Donor-specific blood transfusion is highly successful among first allograft recipients and success in extending the procedure to more disparate relatives is noted.
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
December 1982,
Transplantation,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
February 1986,
Acta medica Okayama,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
September 1981,
Transplantation proceedings,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
February 1987,
Transplantation proceedings,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
May 1982,
American journal of kidney diseases : the official journal of the National Kidney Foundation,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
February 1987,
Transplantation proceedings,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
January 1975,
Transactions - American Society for Artificial Internal Organs,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
January 1983,
Nephrology nurse,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
June 1986,
World journal of surgery,
R Mendez, and
R G Mendez, and
Y I Iwaki, and
T Kinukawa, and
T P Bogaard, and
B A Self, and
P I Terasaki
December 1979,
Transplantation,
