Photochemical Donor Pretreatment in Clinical Kidney Transplantation—Preliminary Report

Oesterwitz, H; Scholz, D; Kaden, J; May, G.; Mebel, M; Schirrow, R.; Blank, William

doi:10.1016/s0022-5347(17)41770-8

Cited by 2 publications

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“…The positive effect is ascribed to decreased graft immunogenicity . To validate these results, a clinical study was performed in 1986, showing that PUVA pre‐treated grafts had a significantly lower number of rejection episodes, although all other outcome parameters were not different . Altogether, PUVA pre‐treatment showed some successes, but since then results have never been validated or reproduced by others.…”

Section: Donor Pre‐treatmentmentioning

confidence: 99%

Donor pre‐treatment in clinical kidney transplantation: a critical appraisal

Vries

Wijermars

Reinders

et al. 2013

Clinical Transplantation

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Kidney transplantation represents one of the medical achievements of the 20th century. However, its continued success is limited by the increasing shortage of donor grafts. As a result, more kidney grafts from marginal donors are being considered for transplantation, with concomitantly more initial graft injury and limited organ and patient survival. This has led to an increased need for interventions aiming to optimize and preserve graft quality. Interventions within the donor may protect against ischemia/reperfusion injury, and therefore, donor pre-treatment is a promising strategy to increase graft function and survival. During the last decade, diverse donor pre-treatment interventions have been explored in animal studies. Moreover, the first human trials concerning donor pre-treatment in kidney transplantation have provided encouraging results. Unfortunately, it remains difficult to determine how and where to intervene in the multifactorial and complex processes that affect the donor kidney. Moreover, ethical matters play a critical role in donor interventions, and pre-treatment should principally not have any potentially unfavorable effects on other organs to be transplanted or on the living donor. This review provides an overview of promising therapeutical strategies for donor pre-treatment in kidney transplantation and discusses the clinical trials that have been conducted thus far.

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Section: Donor Pre‐treatmentmentioning

confidence: 99%

Donor pre‐treatment in clinical kidney transplantation: a critical appraisal

Vries

Wijermars

Reinders

et al. 2013

Clinical Transplantation

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“…These results as well as the relatively simple and safe handling of PUVA therapy seemed to offer a new and effective approach to enhance kidney graft survival also in human beings. In 1987 we reported our first and encouraging results of an unrandomized open study concerning the efficacy of PUVA donor treatment in human kidney transplantation [17]. In comparison with a group of 26 non-pretreated kidneys, in the group of 33 PUVA-pretreated kidneys there were significantly fewer rejection episodes, fewer graft losses by irreversible rejections, fewer infections complications and an improved (but not significantly so) graft survival.…”

Section: Introductionmentioning

confidence: 99%

Effects of PUVA therapy on kidney allografts: results of a randomized prospective double-blind study

et al. 1994

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After successful experimental organ transplant studies on the efficacy of PUVA therapy combining donor pretreatment with the photosensitizer 8-methoxypsoralen (P) and the ex vivo irradiation of organs with long-wave ultraviolet light (UVA) prior to transplantation, we started in 1989 the first randomized, prospective, double-blind study to clarify the efficacy of PUVA therapy in human kidney transplantation. This study included 50 kidney donors, 25 of whom were PUVA-treated. A total of 75 kidneys were transplanted in Berlin, Halle and Rostock. The complete data of these 75 recipients were available for the final evaluation. The PUVA group (n = 36) and the non-PUVA group (n = 39) were not statistically significantly different as to donor and recipient data. Regarding the results, no differences were seen in initial hospitalization time, early graft function, rejection rate, number and time of rejection episodes. After a follow-up of 24 months, both graft survival (PUVA vs. non-PUVA: 75% vs. 71.8%) and patient survival (97.2% vs. 97.4%, respectively) were comparably high. PUVA therapy did not influence the development of vascular rejection. Interestingly, the rate of late graft loss after the 6th posttransplant month was lower, but not statistically significantly so, in the PUVA than in the non-PUVA-group (2 vs. 6 graft losses). Thus, PUVA-pretreated kidneys may be associated with a reduced development of chronic rejection.

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Photochemical Donor Pretreatment in Clinical Kidney Transplantation—Preliminary Report

Cited by 2 publications

References 0 publications

Donor pre‐treatment in clinical kidney transplantation: a critical appraisal

Donor pre‐treatment in clinical kidney transplantation: a critical appraisal

Effects of PUVA therapy on kidney allografts: results of a randomized prospective double-blind study

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