Cadaver Renal Homotransplants: Initial Experiences

Four renal homotransplants were carried out between cadaver donors and four recipients, all of whom were in terminal chronic renal failure. Immune suppression was attempted with azathioprine (Imuran), actinomycin C and prednisone; no radiation was used, nor were the recipient's kidneys, spleen or thymus removed. One patient died with disseminated histoplasmosis at two weeks; another with irreversible homograft rejection at 30 days; a third patient died of septicemia after 9½ weeks with stable renal function. The fourth patient, whose transplant had been ischemic for 190 minutes and had not functioned for 2½ weeks thereafter, eventually achieved good function which remained unchanged to 7½ months. Changes in urinary enzyme excretion and in the I¹³¹ renogram and meralluride scan were of value in assessing homograft rejection.