Renal Transplantation Update

doi:10.1059/0003-4819-100-2-246

Renal Transplantation Update

Los Angeles, California

Abstract

Various factors affect the outcome of renal transplants in humans. Matching for HLA-A, -B, and -DR histocompatibility antigens improves survival rates for renal allografts from first cadaver donors. Zero-HLA-A- and -B-antigen-mismatched grafts and two-HLA-DR-antigen-matched grafts do better, although results differ depending on the recipient's primary renal disease. Pretransplant third-party blood transfusions significantly improve survival rates of cadaver donor allografts. The mechanism of this beneficial effect has not been identified; however, blood transfusions probably do not "select out" high responders among potential recipients by stimulating the production of lymphocytotoxic antibodies. Cyclosporine has been heralded as a potent, nonspecific immunosuppressive agent that will significantly improve renal allograft survival rates. The selectivity of cyclosporine's effect on T lymphocytes is advantageous; however, its side effects, especially nephrotoxicity, may limit its usefulness. Attention to the potential surgical complications of renal transplantation can significantly reduce morbidity and mortality.

Article and Author Information

▸An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine; Los Angeles, California. Director of Conferences: William M. Pardridge, M.D.
▸Authors who wish to cite a section of this conference and specifically indicate its author can use this example for the form of the reference:

ETTENGER RB. Pretransplant blood transfusions and renal transplantation outcome, pp. 248-51. In: FINE RN, moderator. Renal transplantation update. Ann Intern Med. 1984;100:246-57.
Annette V. Terzian, UCLA School of Medicine, provided editorial assistance.
▸Request for reprints should be addressed to Richard N. Fine, M.D.; Department of Pediatrics, Division of Pediatric Nephrology, UCLA School of Medicine; Los Angeles, CA 90024.