The effect of pretransplant stored donor-specific blood transfusions (DSBTs) on renal allograft survival in 108 consecutive one-haplotype living-related donor (LRD) transplant recipients (group A) was compared with a similar consecutive series of 40 one-haplotype LRD recipients (group B) who did not receive DSBTs. All transplant recipients in both groups received identical immunosuppressive protocols using azathioprine and prednisone. One hundred twenty-eight patients received pretransplant stored DSBTs. Twelve of these patients (9%) developed cytotoxic antibodies to their respective donors and those transplants were not performed. Eight patients who had negative final crossmatches with their prospective donor experienced delay or cancellation of their transplants due to late donor withdrawal, or illness of the donor or recipient. Actuarial graft survival for group A and group B patients was compared at 6, 12, 18, and 24 months. Group A graft survival was 94, 90, 90, and 85% and Group B 73, 68, 63, and 63% at the comparison periods. This experience suggests that stored DSBTs are convenient, associated with a low frequency of recipient sensitization, and improved the prospects of success in one-haplotype LRD renal transplantation.