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Renal Transplantation

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Book cover Contemporary Nephrology

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Abstract

Incredibly high rates of engraftment are now routine in many centers. At the August 1986 meeting of the International Transplant Society, it became obvious that we have entered a new era in clinical transplantation. Unsensitized, i.e., patients with sparse anti-HLA antibody reactivity, recipients of primary cadaver donor renal transplants have a 90% + chance of retaining their graft for at least 1 year in many centers. The concept that the various immunosuppressive drugs can be used interchangeably is giving rise to a remarkable and newfound therapeutic flexibility. This does not necessarily mean that it is time to discard the staple items. Azathioprine is back in vogue, at least as part of trendy multidrug regimens. Not suprisingly, the best results are obtained in well-matched and transfused recipients. While many transplant surgeons regard HLA typing as an altogether avoidable nuisance, which may threaten to necessitate organ sharing, the continuing value of HLA typing cannot be denied. Some problems persist in regard to the typing effect; the effect is extremely powerful among certain patient populations and weak among other subsets. The transfusion effect may also be weaker than in years past. On the other hand, donor-specific transfusions may be a discard item.

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Authors and Affiliations

  1. Department of Medicine, Beth Israel Hospital, and Harvard Medical School, Boston, Massachusetts, 02215, USA

    Terry B. Strom

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  1. Terry B. Strom
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  1. Washington University School of Medicine, St. Louis, Missouri, USA

    Saulo Klahr M.D.

  2. University of Southern California School of Medicine, Los Angeles, California, USA

    Shaul G. Massry M.D.

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© 1987 Plenum Publishing Corporation

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Strom, T.B. (1987). Renal Transplantation. In: Klahr, S., Massry, S.G. (eds) Contemporary Nephrology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1859-0_15

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  • DOI: https://doi.org/10.1007/978-1-4613-1859-0_15

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