Donor-Specific Transfusion With Diminished Sensitization

Ja, Light; Metz, Susan; Oddenino, K; Dm, Strong; Simonis, Toni B.; Ja, Biggers; Fernandez-Bueno, Carlos

doi:10.1097/00007890-198212000-00008

Cited by 23 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, the overall percentage of patients sensitized ranged between 5% and 29% (Tables 2 and 3). Although there is some evidence that the administration of immunosuppressive drugs during the application of DST reduces the sensitization rate, several studies revealed a low sensitization rate comparable with our studies (≅10%) without immunosuppression [8,16–18]. From the other studies, it is unknown whether or not sensitization due to DST precluded or delayed subsequent cadaveric transplantation.…”

Section: Discussioncontrasting

confidence: 42%

“…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%

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

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

Marti¹,

Henschkowski²,

Laux³

et al. 2006

Transplant Int

View full text Add to dashboard Cite

show abstract

“…Shelf storage of blood prior to donor-specific transfusion in one-haplotype, living-related donor transplantation has been reported to reduce sensitization without affecting the observed beneficial effect on graft s~r v i v a 1 , 2~.~~ perhaps as a result of the decrease in lymphocytes following storage. 25 The simultaneous administration of lowdose azathioprine also has been found to reduce sensitization with organ donorspecific transfusions.26 Providing transfusions only at the time of transplantation in order to avoid sensitization appears to provide an increase in graft survival which is less than that seen with pretransplant t r a n s f~s i o n s .~~~~~ The use of specific leukocyte-poor preparations, such as frozen or washed RBCs, has been advocated by some as a potential means of reducing sensitization, although the potential benefit of these blood products has been c o n t r~v e r s i a l . '~-~~ Our findings are consistent with previous report^^^-^^ indicating that potential first graft recipients show little increase in sensitization with pretransplant blood transfusions and that there is no significant effect on likelihood of transplantation.…”

Section: Discussionmentioning

confidence: 99%

A randomized study comparing leukocyte‐depleted versus packed red cell transfusions in prospective cadaver renal allograft recipients

Fp¹,

Bollinger

MacQueen

et al. 1985

Transfusion

View full text Add to dashboard Cite

A prospective randomized study at a single renal transplant center between 1980 and 1982 compared the influence of leukocyte-depleted versus packed red cell pretransplantation blood transfusions on patient sensitization to leukocyte (HLA) antigens, likelihood of receiving a graft, and eventual transplantation results. All consenting potential cadaver renal transplant recipients (n = 107) were randomly assigned to receive transfusions at 6-week intervals with either packed red cells (Group 1) or leukocyte-poor red cells (Group 2) until they were transplanted. Actuarial graft and patient survival were identical for graft recipients in both groups. Although the likelihood of receiving a graft was associated with the level of pretransplant sensitization to leukocyte (HLA) antigens (p less than 0.02) as measured by the percent of panel reactive antibody (PRA), it was not associated with the type of blood used. The highest mean peak reactive PRA level for all patients showed a low but significant increase (29 +/- 4 versus 43 +/- 5%; p less than 0.0005) following entry into the transfusion protocol, but the rate of increase was the same for patients in both treatment groups. The likelihood of receiving a transplant was primarily associated with a history of prior graft rejection (p less than 0.05), and patients with prior graft loss had the greatest increase in sensitization following entry into the transfusion protocol. These findings indicate that using leukocyte-poor red cells for pretransplant transfusions provided no added benefit when compared with packed red cells in terms of patient sensitization, the likelihood of receiving a transplant, or eventual graft survival.

show abstract

“…The prevalence of HBV and HCV infections has markedly decreased in patients who are candidates for transplantation since the introduction of screening, hygiene and prevention measures, including systematic vaccination against HBV, screening of blood and organ donations, use of erythropoietin, compliance with universal hygiene rules, and isolation of HBV-infected and HCV positive patients from non-infected patients (Fabrizi et al, 2004). Blood transfusions were common in the past because they were thought to improve graft tolerance and erithropoietin had yet to be approved for this indication (Light et al, 1982). While an anti-Hepatitis B vaccine is indicated in these patients, an anti-HCV vaccine has yet to be developped.…”

Section: Our Experiencementioning

confidence: 99%

The Present Role of Liver Biopsy in Kidney Transplant Candidates in the Management of Hepatitis B and C Patients

Casanovas¹,

Baliellas²,

Cala³

2011

Liver Biopsy in Modern Medicine

View full text Add to dashboard Cite

Donor-Specific Transfusion With Diminished Sensitization

Cited by 23 publications

References 0 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

A randomized study comparing leukocyte‐depleted versus packed red cell transfusions in prospective cadaver renal allograft recipients

The Present Role of Liver Biopsy in Kidney Transplant Candidates in the Management of Hepatitis B and C Patients

Contact Info

Product

Resources

About