Summary
Extended experimental experience with the efficiacy of pretreating the kidney donor and the allograft by means of photochemotherapy (photosensitizer+UVA irradiation=PUVA) was adopted in clinical kidney transplantation. In a preliminary unrandomized study similar patient populations were treated by generally uniform methods. Thirty-three PUVA-pretreated kidneys (group A) were compared with the experience regarding 26 nonpretreated kidney allografts (group B). The number of rejection episodes was significantly lower in the first 3 months in group A (p< 0.05 vs group B) and fewer grafts failed because of irreversible rejection (2 vs 5). Furthermore, in group A the rate of infectious complications was lower (18% vs 34%). The cumulative allograft survival at 3 months was improved from 65% in group B to 81% in group A and at 12 months from 65% 76%, respectively. These differences were not significant. Therefore, our preliminary clinical experience with a photochemical donor pretreatment is encouraging and further use in a randomized study seems to be necessary.
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References
Dienst SG (1977) Statewide donor pretreatment study. Transplant Proc 9:1597–1599
Fox IJ, Sy MS, Benacerraf B, Greene MI (1981) Impairment of antigenpresenting cell function by ultraviolet radiation. Transplantation 31:262–265
Gruner S, Riese C, Schnitzler S, Meffert H, Karasek E (1984) Prolongation of the survival of skin grafts in mice by PUVA treatment. Experientia 40:487–488
Gruner S, Volk HD, Noack F, Meffert H, von Baehr R (1986) Inhibition of HLA-DR antigen expression and of the allogeneic mixed leukocyte reaction by photochemical treatment. Tissue Antigens 27:147–154
Guttmann RD, Morehouse DD, Meakins JL, Klassen J, Knaack J, Beaudoin JG (1978) Donor pretreatment in an unselected series of cadaver renal allografts. Kidney Int 13:99–102
Hardy MA, Lau H, Weber C, Reemstma K (1984) Pancreatic islet transplantation: induction of graft acceptance by ultraviolet irradiation of donor tissue. Ann Surg 200:441–450
Hart DNJ, Fabre JW (1982) Mechanism of induction of passive enhancement. Transplantation 33:319–322
Kaden J, Oesterwitz H, Groth J (1986) Reduced immunogenicity of long-term passively enhanced rat renal allografts and passive transfer of graft protection. Immunol Letters 12: 19–24
Kaden J, Stobelt V, Oesterwitz H, Groth J, May G, Eichler C. Monitoring of renal allograft rejection with fine needle aspiration biospsy and serum c-reactive protein determination. Transplant Proc (submitted)
Kraemer K, Lewis WR, Tarone RE (1981) Inhibition of the MLR by 8-methoxypsoralen and longwave ultraviolet irradiation. J Invest Dermatol 77:235–239
Lafferty KJ, Prowse SJ (1984) Theory and practice of immunoregulation by tissue treatment prior to transplantation. World J Surg 8:187–197
Lafferty KJ (1985) Pancreatic islet transplantation — experimental experience and clinical potential. Western J Med 143: 853–857
Lampe D, Glende M, Scholz D, Blank W, May G, Devaux S, Prümke HJ, Hüller H (1985) Cyclosporin-A drug monitoring nach Nierentransplantation. Dtsch Gesundheitswes 40:1499–1503
Lau H, Reemtsma K, Hardy MA (1984) Prolongation of rat islet allograft survival by direct ultraviolet irradiation of the graft. Science 223:607–609
Managadze LG, Oesterwitz H, Scholz D, May G (1980) Erfahrungen mit der Verwendung kindlicher Leichennieren in der klinischen Nierenallotransplantation. Dtsch Gesundheitswes 35:910–914
McKenzie JL, Beard MEJ, Hart DNJ (1984) Depletion of donor kidney dendritic cells prolongs graft survival. Transplant Proc 16:948–951
Oesterwitz H, Scholz D, Kaden J, Mebel M (1985) Prolongation of rat renal allograft survival time by donor pretreatment with 8-methoxypsoralen and longwave ultraviolet irradiation of the graft (PUVA therapy). Urol Res 13:95–98
Oesterwitz H, Kaden J, Scholz D, Mrochen H, Mebel M (1986) Synergistic effect of donor pretreatment with 8-methoxypsoralen and ultraviolet irradiation of the graft plus azathioprine and prednisolone therapy in prolonging rat renal allograft survival. Urol Res 14:21–24
Oesterwitz H, Kaden J, Scholz D, Mebel M (1986) Donor pretreatment with 8-methoxypsoralen followed by ultraviolet irradiation of the graft: a new approach to enhance rat renal allograft survival. Transplant Proc (in press)
Oesterwitz H, Schneider W. Prolonged rat heart allograft survival by photochemical donor pretreatment. J Surg Res (submitted)
Oesterwitz H, Kaden J, Schneider W, Schirrow R, Scholz D. Synergistic effect of photochemical donor pretreatment and cyclosporin A therapy of the recipient on rat renal allograft survival. Nephrol Dial Transplant (submitted)
Oesterwitz H, Kaden J, Schneider W (1987) Reduced immunogenicity of rat renal allografts after photochemical donor pretreatment and passive transfer of graft protection. Urol Res 15:207–210
Parsons FM (1974) Combined report, including pediatric, on regular dialysis and transplantation in Europe, 1973. Proc Eur Dial Transplant Ass 11:2–67
Rapaport FT, Bachvaroff RJ, Arnold A, Asari H, Sato K, Chanana A, Joel D, Cronkite EP (1985) Implications of dendritic cell-like bone marrow precursors in the induction of allogeneic unresponsiveness to renal allografts. Transplant Proc 17:515–516
Soulillou JP, Baron D, Rouxel A, Guenel J (1979) Steroidcyclophosphamide pretreatment of kidney allograft donors. Nephron 24:193–197
Zincke H, Woods JE, Khan AU, HOlley KE, Leary FJ (1978) Immunological donor pretreatment in combination with pulsatile preservation in cadaveric renal transplantation. Transplantation 26:207–211
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Oesterwitz, H., Scholz, D., Kaden, J. et al. Photochemical donor pretreatment in clinical kidney transplantation —Preliminary report. Urol. Res. 15, 211–213 (1987). https://doi.org/10.1007/BF00262102
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DOI: https://doi.org/10.1007/BF00262102