Current strategy for donor-specific blood transfusions including a pre- and post transplant role for azathioprine.

The optimal use of the DST protocol has been defined with a preference for the protocol in patients undergoing a first transplant with a low pre-DST PRA. Azathioprine coverage during DST administration in this group assures a low sensitization rate. In addition, a posttransplant immunosuppressive protocol is introduced that includes very low-dosage P and Cs therapy along with limited-dose Aza. Preliminary results appear to indicate that this may possibly further improve graft survival; but, most importantly, it will reduce problems and complications associated with steroid and Cs therapy.