Prophylactic deoxyspergualin treatment in living-related renal-transplant recipients transfused with donor-specific blood

Prophylactic deoxyspergualin treatment in living-related renal-transplant recipients transfused with donor-specific blood

Deoxyspergualin (DSG) prophylaxis has improved long-term graft survival in living-related renal-transplant recipients transfused with donor-specific blood (DST). We examined the influence of acute rejection (AR) on graft survival in these patients. The study groups consisted of either historic contr...

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Bibliographic Details
Published in:Transplantation Vol. 75; no. 1; pp. 60 - 66
Main Authors: ANADA, Noritoshi, OKAZAKI, Hajime, SATO, Takaomi, MIURA, Shunji, OHASHI, Yoichi
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott 15-01-2003
Subjects:
Adolescent
Adult
Biological and medical sciences
Blood Transfusion
Child
Female
Graft Rejection - epidemiology
Graft Survival - drug effects
Guanidines - therapeutic use
Histocompatibility Testing
HLA-DR Antigens - immunology
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Kidney Transplantation - immunology
Living Donors
Male
Medical sciences
Middle Aged
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Human
Graft(material)
Prognosis
Acute
Living donor
Related donor
Transplantation
Homotransplantation
Gusperimus
Long term
Survival
Kidney
Blood
Prevention
Rejection
Treatment
Surgery
Graft
Blood donor
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Summary:Deoxyspergualin (DSG) prophylaxis has improved long-term graft survival in living-related renal-transplant recipients transfused with donor-specific blood (DST). We examined the influence of acute rejection (AR) on graft survival in these patients. The study groups consisted of either historic control recipients without DSG (group A, n=64, 1985-1989) and recipients with DSG as the initial immunosuppressive agent (group B, n=76, 1989-1995). Both groups received DST from a one-haplotype identical donor and were treated with cyclosporine-based immunosuppression. Rejection was classified into accelerated rejection (Acc, within 5 days), AR (from 6 days-3 months), and late AR (LAR, from 4 months-1 year). Overall 5-year graft survival rates were significantly higher in group B than group A (89.5 vs. 73.4%, P=0.0070). Each group was then subdivided on the basis of whether or not they had an episode of Acc, AR, or LAR. In group A, 5-year graft survival rate was not affected the presence or absence of Acc (75.0 vs. 73.1%), and it was influenced significantly by the presence or absence of AR (50.0 vs. 85.7%, P=0.0012) or LAR (46.7 vs. 81.6%, P<0.0001). In group B, 5-year graft survival did not change significantly by the presence or absence of Acc (100 vs. 88.7%), AR (81.8 vs. 92.6%), or LAR (81.0 vs. 92.7%). Prophylactic use of DSG in living-related renal-transplant recipients treated with DST improves long-term graft survival, even in patients with AR episodes.
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ISSN:0041-1337
1534-6080
DOI:10.1097/00007890-200301150-00011