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

Amada, Noritoshi; Okazaki, H; Sato, Tatsuya; Miura, S; Ohashi, Y

doi:10.1097/00007890-200301150-00011

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…Traditionally, DST protocols have been highly variable with respect to the use of whole blood [1,2,5,8, 10,12,13,16–22] versus buffy coat [3,7,9,10,12,18,21], stored [5,8,16,17,20,21] versus fresh [1,2,7,13,21,22] transfusions, actual number of administered DST, presence or absence of various types of immunosuppressive coverage, time interval between DST and transplantation and duration of follow‐up (Tables 2 and 3). A major deficiency of these investigations was the controls considered.…”

Section: Discussionmentioning

confidence: 99%

“…A major deficiency of these investigations was the controls considered. Some of the studies had no controls at all [3,9,20,21], others focused either on historical [13,17–19] or on a kind of parallel control group [1,2,4,5,7,8,11,12]. The present investigation appears to be the only one, which considered well‐matched individuals.…”

Section: Discussionmentioning

confidence: 99%

“…DST were introduced with the aim to induce unresponsiveness to allografts by modulation of the immune system [1,2]. After the introduction of cyclosporine, the beneficial effects of DST became controversial and were often not detectable [3–7]. Therefore, most transplant centers have abandoned such protocols.…”

Section: Introductionmentioning

confidence: 99%

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Effect of donor-specific transfusions on the outcome of renal allografts in the cyclosporine era

Marti¹,

Henschkowski²,

Laux³

et al. 2006

Transplant Int

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Summary Despite the introduction of new immunosuppressive agents, a steady decline of functioning renal allografts after living donation is observed. Thus nonpharmacological strategies to prevent graft loss have to be reconsidered, including donor‐specific transfusions (DST). We introduced a cyclosporine‐based DST protocol for renal allograft recipients from living‐related/unrelated donation. From 1993 to 2003, 200 ml of whole blood, or the respective mononuclear cells from the potential living donor were administered twice to all of our 61 recipient candidates. The transplanted subjects were compared with three groups of patients without DST from the Collaborative Transplant Study (Heidelberg, Germany) during a 6‐year period. Six patients were sensitized without delay for a subsequent cadaveric kidney. DST patients had less often treatment for rejection and graft survival was superior compared with subjects from the other Swiss transplant centers (n = 513) or from Western Europe (n = 7024). To diminish the probability that superior results reflect patient selection rather than effects of DST, a ‘matched‐pair’ analysis controlling for relevant factors of transplant outcome was performed. Again, this analysis indicated that recipients with DST had better outcome. Thus, our observation suggests that DST improve the outcome of living kidney transplants even when modern immunosuppressive drugs are prescribed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of donor-specific transfusions on the outcome of renal allografts in the cyclosporine era

Marti¹,

Henschkowski²,

Laux³

et al. 2006

Transplant Int

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Immunosuppressive Drugs

Braun¹,

Becker²,

Renders³

et al. 2012

Encyclopedia of Life Sciences

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Immunosuppressive drugs are used for the prevention or treatment of rejection after transplantation of solid organs, tissues and cells, as well as therapy of autoimmune and a variety of other diseases. Primary goals of immunosuppression are: (1) to effectively control immune responses against foreign antigens and (2) to minimise any undesired drug side effects and toxicities. The development of numerous substances, together with the understanding of their molecular action has paved the way to meet these goals, and to individualise immunosuppression. The objective of this inventory is to give a systematic overview on immunosuppressive agents currently in use or under evaluation for transplantation, as a guide for scientific research and clinical practice. Key Concepts: Immunosuppressive drugs are required for prophylaxis and therapy of rejection in solid organ transplantation. A broad spectrum of immunosuppressive drugs is available and new drugs are in the pipeline or under development. Some immunosuppressive drugs are critical dose drugs with a narrow therapeutic index and require therapeutic drug monitoring. Calcineurin inhibitors are commonly used as the basic immunosuppressives despite their nephrotoxic potential. Immunosuppressive drug combinations with different mode of actions are helpful to lower single drug dosages and avoid drug‐related adverse effects as well as to use synergistic or additive immunosuppressive effects. Many factors (e.g. age, gender, liver or renal dysfunction, genetic polymorphism, drug–drug interactions, etc.) can alter the pharmacokinetics of immunosuppressive drugs. Withdrawal of immunosuppressive medication in solid organ transplantation can cause graft failure.

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Transfusion sanguine et transplantation

Matignon

Bonnefoy

Lang

et al. 2011

Transfusion Clinique et Biologique

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

Abstract: Prophylactic use of DSG in living-related renal-transplant recipients treated with DST improves long-term graft survival, even in patients with AR episodes.

Cited by 6 publications

References 19 publications

Effect of donor-specific transfusions on the outcome of renal allografts in the cyclosporine era

Effect of donor-specific transfusions on the outcome of renal allografts in the cyclosporine era

Immunosuppressive Drugs

Transfusion sanguine et transplantation

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