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Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants.

Publication ,  Journal Article
Reed, A; Pirsch, J; Armbrust, MJ; Burlingham, WJ; Knechtle, SJ; D'Alessandro, AM; Sollinger, HW; Lorentzen, D; Kalayoglu, M; Belzer, FO
Published in: Transplantation
February 1991

A total of 127 haploidentical living-related transplants have been performed at our institution since March 1986. A donor-specific transfusion plus azathioprine protocol was used until July 1988 (n = 74) and a random transfusion (RT) protocol without AZA used thereafter (n = 53) in an effort to decrease risk of recipient sensitization and reduce the burden on the prospective donor. All patients were given cyclosporine 8 mg/kg/day orally beginning 1 week prior to transplantation. Immunosuppression was similar in both groups and consisted of triple induction therapy with prednisone, CsA, and AZA. A positive T cell crossmatch eliminated the potential donor. Seven individuals (9.6%) were sensitized in the DST group and 1 (1.9%) in the RT group, leaving 67 and 52 patients in the two groups of the study, respectively. Groups were similar with respect to age, sex, history of pregnancy in female patients, peak and baseline panel-reactive antibody (PRA), DR match, and prior transplants. The groups differed slightly with respect to AB antigens shared, with an advantage in the RT group. Actuarial graft survival was not statistically significantly different between the two groups, with 2-year graft survival of 95% in the DST and 91% in the RT group (log rank, P = 0.16). Patients in the RT group had significantly more rejection episodes and had them sooner than their counterparts in the DST group. At the end of 1 year, 50% of patients in the DST group had at least 1 rejection episode, compared with 75% of patients in the RT group (P = 0.0008). Multivariate (Poisson) analysis of 10 variables was performed, with an overall model P-value of 0.0001. Only DST (P = 0.0001) and pregnancy (P = 0.015) were significant predictors of rejection episodes, both protective. The difference in rejection episodes and the timing with which they occur has not yet translated into a significant difference in graft survival between DST and RT groups.

Duke Scholars

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

February 1991

Volume

51

Issue

2

Start / End Page

382 / 384

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Sex Factors
  • Parity
  • Multivariate Analysis
  • Male
  • Kidney Transplantation
  • Humans
  • Histocompatibility
  • Haplotypes
 

Citation

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Reed, A., Pirsch, J., Armbrust, M. J., Burlingham, W. J., Knechtle, S. J., D’Alessandro, A. M., … Belzer, F. O. (1991). Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants. Transplantation, 51(2), 382–384. https://doi.org/10.1097/00007890-199102000-00022
Reed, A., J. Pirsch, M. J. Armbrust, W. J. Burlingham, S. J. Knechtle, A. M. D’Alessandro, H. W. Sollinger, D. Lorentzen, M. Kalayoglu, and F. O. Belzer. “Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants.Transplantation 51, no. 2 (February 1991): 382–84. https://doi.org/10.1097/00007890-199102000-00022.
Reed A, Pirsch J, Armbrust MJ, Burlingham WJ, Knechtle SJ, D’Alessandro AM, et al. Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants. Transplantation. 1991 Feb;51(2):382–4.
Reed, A., et al. “Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants.Transplantation, vol. 51, no. 2, Feb. 1991, pp. 382–84. Pubmed, doi:10.1097/00007890-199102000-00022.
Reed A, Pirsch J, Armbrust MJ, Burlingham WJ, Knechtle SJ, D’Alessandro AM, Sollinger HW, Lorentzen D, Kalayoglu M, Belzer FO. Multivariate analysis of donor-specific versus random transfusion protocols in haploidentical living-related transplants. Transplantation. 1991 Feb;51(2):382–384.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

February 1991

Volume

51

Issue

2

Start / End Page

382 / 384

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Sex Factors
  • Parity
  • Multivariate Analysis
  • Male
  • Kidney Transplantation
  • Humans
  • Histocompatibility
  • Haplotypes