Renal donor pretreatment with cytotoxic agents: immunologically ineffective and damaging to the graft.

Simultaneous double renal allografts were performed in 32 dogs to evaluate the effect of pretreatment of the donor kidney with either Medrol, cytoxan, and methotrexate or medrol and procarbazine. There was no prolongation of survival of treated allografts. Immunosuppressive therapy for the transplanted animal unmasked a pretreatment injury of the pretreated kidney. Treatment of an autograft kidney in an intermediate host produced a cytotoxic tubular lesion in the kidney and also appeared to protect the kidney from the double ischemic insult incurred during the transplantation procedure. Pretreatment of dog donors of renal allografts with cytotoxic agents thereby offers no immunologic advantage for graft survival and produces a cytotoxic tubular lesion that is detrimental to kidney survival when ischemic and immunologic injury is minimal.