Successful transplantation of cyclosporine-treated haploidentical living-related renal recipients without blood transfusions.

A protocol of cyclosporine and prednisone immunosuppression was used in 36 consecutive haploidentical living-related renal transplant recipients from donors displaying marked proliferation in mixed lymphocyte culture (MLC) reactions. All blood transfusions (random third-party and donor-specific) were withheld once a negative crossmatch with the prospective kidney donor was obtained. With a mean follow-up of 13.6 months, patient survival is 97% (35/36) and graft survival is 92% (33/36). One graft was lost to rejection; two were abandoned because of sepsis. Only 14% (5/36) of patients experienced a rejection episode. No significant differences were evident in graft survival, rejection episodes, or renal function between the 15 recipients who were never transfused and the 21 with a history of previous blood transfusions. These findings suggest that pretransplant blood transfusions not only are unnecessary to achieve excellent graft survival, but also may jeopardize donor availability by donor-specific presensitization.