Barry J M, Craig D H, Fischer S M, Fuchs E F, Lawson R K, Bennett W M
J Urol. 1980 Dec;124(6):783-6. doi: 10.1016/s0022-5347(17)55662-1.
A multifactorial analysis of 100 consecutive first cadaver kidney transplants was done to document the current status of this treatment for end stage renal disease and to determine the influence of the following variables on kidney losses owing to rejection: splenectomy, pre-transplant transfusions, transfusion at the transplantation, recipient sex, pre-transplant nephrectomy, donor and recipient A, B or O blood group, human leukocyte A and B antigen mismatches, kidney preservation method, donor treatment with methylprednisolone and cyclophosphamide, recipient treatment with antilymphocyte serum or antilymphoblast globulin and a low dose of steroid treatment for rejection. Pre-transplant splenectomy for leukopenia, 5 or more pre-transplant blood transfusions and pre-transplant transfusions without development of circulating cytotoxic antibodies significantly reduced kidney losses owing to rejection (p less than 0.05)., A low dose of steroid treatment for rejection resulted in a trend towards improved patient survival without sacrificing kidney graft survival. Clinical studies demonstrating decreases in kidney graft rejection should be controlled for pre-transplant blood transfusions and, possibly, for pre-transplant splenectomy for hypersplenism.
对100例连续的首例尸体肾移植进行了多因素分析，以记录这种终末期肾病治疗方法的当前状况，并确定以下变量对因排斥反应导致的肾丢失的影响：脾切除术、移植前输血、移植时输血、受者性别、移植前肾切除术、供者和受者的A、B或O血型、人类白细胞A和B抗原错配、肾脏保存方法、供者用甲基泼尼松龙和环磷酰胺治疗、受者用抗淋巴细胞血清或抗淋巴母细胞球蛋白治疗以及用低剂量类固醇治疗排斥反应。因白细胞减少进行移植前脾切除术、5次或更多次移植前输血以及移植前输血但未产生循环细胞毒性抗体，可显著减少因排斥反应导致的肾丢失（p<0.05）。用低剂量类固醇治疗排斥反应有改善患者生存率的趋势，且不影响肾移植存活。证明肾移植排斥反应减少的临床研究应控制移植前输血情况，可能还应控制因脾功能亢进进行的移植前脾切除术情况。
