Hla-Matching and Pretransplant Blood Transfusions in Cadaveric Renal Transplantation—a Changing Picture With Cyclosporin

Lundgren, G; Albrechtsen, D; Flatmark, A; Gäbel, H; Klintmalm, Göran B.; Persson, Hans; Groth, Carl‐Gustav; Brynger, H; Frødin, L; Husberg, B; Mäurer, W; Thorsby, E.

doi:10.1016/s0140-6736(86)91608-9

Cited by 82 publications

(20 citation statements)

References 11 publications

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“…31 Also in large materials, a beneficial effect of HLAmatching was usually most evident with high degrees of HLA-matching. 6,27 The absence of a blood transfusion effect is in accordance with most reports during recent years 29,32 and it is probably generally agreed upon today that pre-transplantation blood transfusions should be avoided. 33 The major obstacle to transplantation in Saudi Arabia is the low donation rate from CD as well as LRD.…”

Section: Discussionsupporting

confidence: 80%

“…26 A surprising finding was the correlation between HLA-matching and GS in the CD series, especially considering the limited material. Such a correlation was reported in large multicenter materials 6,27,28 but was usually absent in smaller multicenter 29,30 and single center studies. 31 Also in large materials, a beneficial effect of HLAmatching was usually most evident with high degrees of HLA-matching.…”

Section: Discussionmentioning

confidence: 76%

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Kidney Transplantations at King Faisal Specialist Hospital and Research Centre

Lundgren

Alfurayh

Akhtar

et al. 1994

Annals of Saudi Medicine

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During the five year period from 1987G to 1991G, 161 kidney transplantations were performed at King Faisal Specialist Hospital and Research Centre (KFSH&RC); 79 from cadaveric donors (CD) and 82 from living related donors (LRD). All cadaveric kidneys except one were harvested within Saudi Arabia and 67% were from Saudi nationals. The immunosuppressive protocol was a triple drug regimen comprising cyclosporin-A (CyA), azathioprine (Aza), and prednisone. The actuarial graft survival rates at one and three years were 85% and 76% for the cadaveric donor transplants and 96% and 91%, respectively for the living related donor transplants (P<0.01). The corresponding patient survival rates for cadaveric donor transplants (CDTxs) were 97% and 94% and for the living related donor transplants (LRDTxs), 99% and 97% (NS). These results compare well with the best results in the Western world. The most serious surgical complications were vascular thromboses (five cases) and infections of the arterial anastomosis line with bleeding (two cases), all leading to loss of the cadaveric graft. The most common causes of death were virus infection, varicella, cytomegalovirus, and hepatitis B and C. The organ donation rate, from cadaveric donors as well as living related donors, is still low in Saudi Arabia. Lack of organs is the main obstacle to an expansion of this promising transplantation activity. Continuous education of the multinational medical profession as well as the lay population is necessary to improve the situation.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 76%

Kidney Transplantations at King Faisal Specialist Hospital and Research Centre

Lundgren

Alfurayh

Akhtar

et al. 1994

Annals of Saudi Medicine

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“…In Sweden the recommended plasma level the first month after transplantation is 100-500 gg/ml [12]. These concentrations of CyA only affected HSV production in vitro when cells were infected at low m.o.i.s (less then 0.1 PFU/cell).…”

Section: Discussionmentioning

confidence: 97%

Inhibition of herpes simplex virus production in vitro by Cyclosporin A

Vahlne

Horal

et al. 1992

Archives of Virology

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Nontoxic concentrations of Cyclosporin A (CyA) dose-dependently inhibited herpes simplex virus (HSV) production in resting monkey kidney cells. The block was at the step of virus DNA synthesis as assessed by [3H]thymidine incorporation and by dot blot hybridization of infected cell DNA using a cloned 32P-labelled HSV DNA fragment (BamHI X) as probe. This was further supported by analysis of HSV protein synthesis in the presence of CyA as assessed by sodium dodecyl sulphate polyacrylamide gel electrophoresis and Western blot. A relative accumulation of HSV alpha- (e.g., ICP 4) and beta 1-proteins (e.g., ICP 6 and 8) was found, whereas HSV gamma 1-proteins were slightly decreased and gamma 2-proteins were markedly decreased by CyA. The production of thymidine kinase and DNA polymerase was decreased when CyA was added to HSV infected cells. The sensitivity to CyA was not escaped by thymidine kinase nor DNA polymerase deficient mutants. Passage of HSV in presence of CyA did not result in induction of drug resistance.

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“…Recent evidence suggests that the blood transfusion effect remains in certain circumstances, when one considers effects of HLA antigens, rejection episodes, and possibly the prospects of tolerance induction. In a single centre study of a notransfusion policy, the non-transfused group had more early rejection episodes (Lundgren 1986). Another study on the relation of rejection activity to previous blood transfusions showed that 63% of the 231 non-transfused recipients had rejection episodes during the first 60 days after transplantation, while 48% of the transfused patients had rejection (Toyotome 1987).…”

Section: History Of Blood Transfusion Effect In Clinical Transplantationmentioning

confidence: 99%