Comparison of the immunosuppressive effect of fractionated total lymphoid irradiation (TLI) vs conventional immunosuppression (CI) in renal cadaveric allotransplantation

Journal Article · Wed Feb 01 04:00:00 EST 1984 · J. Immunol.; (United States)

OSTI ID:5071919

Waer, M; Vanrenterghem, Y; Ang, K K; van der Schueren, E; Michielsen, P; Vandeputte, M

Beginning in November 1981, eight patients with end stage diabetic nephropathy underwent renal cadaveric transplantation after TLI. Transplantation was done between 2 to 11 days after the end of a fractionated TLI to a total dose of 20 to 30 Gy. During the same observation period, 60 nondiabetic patients with end stage renal disease of different origin also received a cadaveric kidney graft, with a conventional regimen of immunosuppression that consists of anti-lymphocyte-globulin, tapering high doses of prednisone, and azathioprine. Phytohemagglutinin (PHA)-, concanavalin A (con A)-, and pokeweed mitogen (PWM)-induced blastogenesis, as well as the mixed lymphocyte reaction (MLR) and the cell-mediated lympholysis (CML) decreased progressively during the first months after conventional immunosuppression to 50% of the pretransplantation level, and remained there for the first year after transplantation. These tests were much more impaired after TLI and again no recovery occurred during the first year. In the clinic, the more profound immunosuppression in TLI patients was more frequently associated with viral infections (cytomegalovirus and herpes zoster). The incidence of rejections, however, was somewhat less frequent in the TLI-treated group and occurred significantly later. After TLI, the mean cumulative dose of steroids needed for kidney transplantation during the first year after transplantation could be substantially reduced.

• Research Organization: Univ. of Leuven, Belgium
• OSTI ID: 5071919
• Journal Information: J. Immunol.; (United States), Journal Name: J. Immunol.; (United States) Vol. 132:2; ISSN JOIMA
• Country of Publication: United States
• Language: English

Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ADRENAL HORMONES
ANIMAL CELLS
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CONNECTIVE TISSUE CELLS
CORTICOSTEROIDS
EXTERNAL IRRADIATION
FRACTIONATED IRRADIATION
GLOBULINS
GLUCOCORTICOIDS
HORMONES
HYDROXY COMPOUNDS
IMMUNOGLOBULINS
IMMUNOLOGY
IMMUNOSUPPRESSION
IRRADIATION
KETONES
KIDNEYS
LEUKOCYTES
LYMPHATIC SYSTEM
LYMPHOCYTES
MATERIALS
ORGANIC COMPOUNDS
ORGANS
PARTIAL BODY IRRADIATION
PHYSIOLOGY
PREDNISONE
PREGNANES
PROTEINS
RADIOINDUCTION
SOMATIC CELLS
STEROID HORMONES
STEROIDS
TRANSPLANTS