1985 Volume 76 Issue 12 Pages 1824-1829
From September, 1973 to October, 1984, 103 living related and 1 living unrelated kidney transplantations were performed on 103 patients with end stage renal failure. Five of the 103 recipients were transplanted from HLA two haploidentical donors and 97 from HLA one haploidentical donors. 102 recipients received primary grafts and 2 secondary grafts. 87 of the 103 recipients had a history of pretransplant blood transfusion.
The recipient and the allograft survival rates in the entired series were 95.7% & 80.5%, respectively, at 1 year, 85.0% & 67.9% at 3 years, 78.1% & 56.2% at 5 years and 71.8% & 50.6% at 10 years.
Of 97 recipients with kidneys from HLA one haploidentical donors, the first 20 received standard immunosuppression with steroid and azathioprine. The next 42 received short term ALG in addition to the standard immunosuppression. In these 42 recipients, rejection episodes were treated with low doses of steroid. Of the third 42 recipients, 33 received thoracic duct drainage pretreatment and the standard immunosuppression, and 9 received new immunosuppression with cyclosporine and steroid.
From the results observed in these three groups, it was indicated that (1) a low dose of steroid treatment for rejection resulted in a trend towards improved recipients' survival without sacrifing kidney graft survival. (2) the TDD pretreatment yieled beneficial effects on graft survival.
