[Thoracic duct drainage pretreatment in living related kidney transplantation--long-term results of low dose steroid and azathioprine immunosuppression].

The long term results of 28 HLA 1-haploidentical donor kidney transplant recipients receiving preoperative lymphocyte deletion through thoracic duct drainage and low dose of steroid and azathioprine immunosuppressive treatment were presented. The number of removed lymphocytes was 129.9 +/- 38.1 x 10(9) (mean +/- SD) and the duration of thoracic duct drainage pretreatment was 35 +/- 4 days. Graft survival was 96% at 3 months through 2 years, 89% at 3 years and 84% at 5 years. Patient survival was 100% at 3 months through 2 years and 96% at 3 years through 5 years. Fifteen acute rejection crises were observed in 13 patients within the first 3 months postoperatively. There was no irreversible rejection in the first 3 months. Four chronic rejections were observed in 4 patients. Life-threatening infectious disease was observed in 5 patients, diabetes mellitus in 2 and cataract in 4. These results indicated that the reduction of the dose of steroid in post transplant period might have beneficial effects on the long term graft survival of HLA 1-haploidentical kidney transplant patients receiving TDD pretreatment and the conventional immunosuppressive treatment.