LONG-TERM RESULTS WITH 45 LIVING RELATED RENAL-ALLOGRAFT RECIPIENTS GENOTYPICALLY IDENTICAL FOR HLA

  • 1 January 1977
    • journal article
    • research article
    • Vol. 81  (3) , 274-283
Abstract
During the past decade 45 living related renal allografts were performed between siblings genotypically identical for HL-A. In each case all available family members were serotyped, and haplotype analysis was performed. Immunosuppressive therapy consisted of standard azathioprine and prednisone regimens. Only 1 instance of HL-A-D incompatibility was documented. HL-A-A, -B haplotypes were identical in each case. Histopathological evaluation by light microscopy, immunofluorescence and EM was completed. Four patients experienced acute cellular rejection with mild long-term impaired renal function. Five patients had acute cellular rejection but subsequently experienced long-term normal renal function. Patients (23) had little or no rejection documented and half of these patients are being maintained without steroid therapy. Five patients had histologically proven acute humoral rejection; 3 subsequently lost their allografts; 20 regained relatively normal renal function. Recurrent glomerulonephritis was documented in 6 cases. One was lobular, 1 crescentic and 1 demonstrated dense-deposit membranoproliferative glomerulonephritis. Three cases of IgA [immunoglobulin A] nephropathy were diagnosed. In each case the recurrent glomerulonephritis reflected the same histopathology and clinical course as the disease realized in the host kidneys. Of the 40 surviving patients, 87% were fully rehabilitated.

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