Effect of pretransplant transfusions on kidney allograft survival
article
The results obtained in prospective studies with unrelated rhesus monkeys confirm the impressions gained by the majority of the clinical investigators that pretransplant blood transfusions lead to prolongation of kidney graft survival. The monkey data indicate that several transfusions prior to transplantation give a more consistent prolongation of graft survival than a single one. Further, it appeared in the rhesus model that a single transfusion of whole blood or pure erythrocytes can lead to accelerated rejections, except when optimally matched whole blood (no disparities for SD antigens with kidney donor and recipient) was given. If we extrapolate the monkey data to the clinical situation, the observation of occasional accelerated rejections makes it hazardous to advocate a rigid transfusion policy for patients at this stage. Although it is clear that blood transfusions usually have a beneficial influence on graft survival, the intentional administration of pretransplant transfusions should be approached with necessary caution. The mechanism responible for the transfusion effect is still unknown. However, it has been shown that the rhesus monkey provides an experimental model which should enable us to investigate the mode of action of the effect in properly controlled prospective studies. Only when guided by the results of such studies will it be possible to make meaningful recommendations for a transfusion policy in clinical kidney transplantation.
Chemicals/CAS: ABO Blood-Group System; Isoantibodies
Chemicals/CAS: ABO Blood-Group System; Isoantibodies
Topics
TNO Identifier
228749
ISSN
00411345
Source
Transplantation Proceedings, 11(1), pp. 127-137.
Pages
127-137
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