An alternative, effective pretransplant transfusion method: Small-aliquot, repeated transfusions from the same third-party, HLA-defined blood donor

We have used an unusual if not unique method of transfusion for the prospective, previously untransfused recipients of living related (LR) or cadaveric (CAD) first renal grafts. A single unit of third-party, HLA-defined blood is administered in three aliquots to these patients before grafting. The technique is based on the hypothesis that it is the repeated administration of mismatched HLA-DR in a 'booster' fashion that is responsible for maximizing graft survival. This unique method of pretransplant transfusion is safe, effective, and conserved blood. It compares favorably with other transfusion protocols and appears to augment the results in Cs-treated patients. It will not sensitize recipients to their related kidney donors and eliminates the need to treat these recipients with immunosuppressive agents during the transfusion period. It has the potential of minimizing the sensitization profile of prospective CAD kidney recipients to only a few selected mismatched major histocompatibility antigens.