Renal homotransplantation in man after radiation of the recipient: Experience with six patients since 1959

Abstract

A healthy kidney of a parent or sibling was transplanted in the sublethally irradiated (430 to 460 rad) recipient with advanced chronic renal insufficiency. Three of the 6 cases showed prolonged tolerance to the grafter kidney, although 1 of the 3 died following further radiation therapy. In 2 of the unsuccessful cases, the graft was rejected within 48 hr, and a 3rd case died from an early infection. Renal function appeared to be normal after more than 1 yr in the 2 surviving successful cases, and biopsy showed normal glomerular structure. Radiation treatment was not accompanied by a diminution of pre- existing circulating antibodies (blood-group isohemagglutinins), but it apparently reduced formation of antibodies in response to antigens in the transplanted kidney. In cases of early rejection of the graft, differences were noted in leukocyte agglutination reactions between donor and recipient, but in all cases the major erythrocyte blood groups were the same in the 2 individuals. (H.H.D.)