The Beneficial Effects of Thoracic Duct Drainage in HLA-1 Haplotype Identical Kidney Transplantation

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Abstract
The beneficial effects of pre-treatment thoracic duct drainage on graft survival in living related kidney transplantation are presented. Since July 1980 lymphocyte depletion through thoracic duct drainage has been used as pre-treatment therapy in 39 HLA-1 haplotype identical living related kidney transplant patients. Thoracic duct drainage was maintained for 29 to 49 days (mean 36 days) before transplantation and 52 to 215 times 109 cells (mean 130 times 109 cells) were removed. Postoperative immunosuppression consisted of azathioprine and steroids. Actuarial graft survival was 100 per cent at 3 months, 97 per cent 6 months through 2 years, 92 per cent at 3 year and 57 per cent at 4 years after transplantation. Patient survival was 100 per cent at 3 months, 97 per cent at 6 months through 3 years and 86 per cent at 4 years. Pre-treatment thoracic duct drainage maintained for more than 28 days could have a significant role on the improvement of the graft survival in HLA-1 haplotype identical kidney transplantation.