An Analysis of 100 Primary Cadaver Kidney Transplants

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Abstract
A multifactorial analysis of 100 consecutive 1st cadaver kidney transplants documented the current status of this treatment for end stage renal disease and determined the influence of the following variables on kidney losses owing to rejection: splenectomy, pre-transplant tranfusions, transfusion at the transplantation, recipient sex, pre-transplant nephrectomy, donor and recipient A, B or O blood group, HLA-A and HLA-B mismatches, kidney preservation method, donor treatment with methylprednisolone and cyclophosphamide, recipient treatment with antilymphocyte serum or antilymphoblast globulin and a low steroid treatment dose for rejection. Pre-transplant splenectomy for leukopenia, 5 or more pre-transplant blood transfusions and pre-transplant transfusions without development of circulating cytotoxic antibodies significantly reduced kidney losses owing to rejection (P < 0.05). A low steroid treatment dose for rejection resulted in a trend towards improved patient survival without sacrificing kidney graft survival. Clinical studies demonstrating decreases in kidney graft rejection should be controlled for pretransplant blood transfusions and, possibly, for pre-transplant splenectomy for hypersplenism.