Donor-specific transfusion.

Abstract

1. Since 1982, approximately 25% of recipients with living donor grafts were treated with DST. 2. With DST the one-year graft survival was 95% with HLA-identical siblings, 86% with parental donors, 92% with offspring, 87% with one-haplotype different siblings, and 85% with zero-haplotype different siblings. These rates were 2 to 11% higher than with comparable non-DST transplants. 3. At 3 years the parental donor transplants with more than three DST had the highest survival rate of 82% followed by greater than 3 RDT with a 76% survival rate which was considerably higher than the 3-year survival of 63% in nontransfused parental donor grafts. 4. The 3-year survival rate of DST HLA-identical sibling donor grafts was 83% but randomly transfused patients had a 90% 3-year survival in contrast to 79% in patients without transfusions. 5. Cyclosporine treatment did not significantly improve graft survival in parental donor grafts except in the zero transfusion group (from 73 to 85% at one year). Sibling donor and HLA-identical donor grafts were improved slightly by cyclosporine treatment.