The effect of transfusions and donor pretreatment on canine renal allograft survival

Allograft survival is influenced by a complexity of known and unknown factors. The effect of several types of transfusion on renal allograft survival has been studied in mongrel dogs. Nontreated and drug-pretreated kidneys were transplanted. Preoperative and peroperative cell suspensions of unrelated dogs were transfused to graft recipients. All recipients received low-dose postoperative immunosuppression. One peroperative transfusion of 100 ml third-party blood enhanced graft survival of nontreated kidneys significantly. A transfusion of 100 ml blood 14 days before transplantation led to variable results, whereas a transfusion of cells obtained from a third party spleen, given 14 days before transplantation, did not prolong graft survival of nontreated kidneys at all. The administration of procarbazine hydrochloride and methylprednisolone to the donor before procuring the graft increased survival of canine renal allografts significantly. A combination of donor drug pretreatment and 100-ml peroperative third-party blood led to graft survival comparable to that obtained by either treatment. Pretreatment of the recipient with spleen cells 14 days before transplantation even abrogated the effect of donor drug pretreatment completely. These results show that preoperative transfusions cannot successfully be combined with donor drug pretreatment as commonly practiced in man. This is a possible explanation for the conflicting data on donor pretreatment in man. Furthermore this study gives evidence for the effectiveness of a peroperative blood transfusion on kidney graft survival.