Modification of kidney graft survival in dog and man by pre-operative transfusion to the donor.

The present experiments indicate that the transplantation reaction is not solely caused by immunocompetent cells of the recipient, but also by immunocompetent cells in the donor organ. Immunisation of the donor did modify the immune response as demonstrated with kidney grafts in rat, dog and man. In the dog prolonged kidney graft survival by one peroperative blood transfusion was reduced to control level by transfusion of the donor on day -1 with 100ml third party blood. In the rat third party blood transfusion to the donor reduced kidney graft survival significantly, but donor pretreatment with recipient lymphocytes induced significantly prolonged survival. This suggests that the modification of graft survival by donor transfusion is an immunological phenomenon. Immunisation of the donor with recipient cells may induce specific immunoreactive cells in the graft that causes a local graft versus host reaction, which inhibits the rejection reaction. In man 44 recipients were studied who only received blood peroperatively. Significantly impaired graft survival was noted if the donor was not transfused, resulting in 19% 3-month kidney function, versus 61% with transfused donors.