Results in live-donor renal transplantation: The SEOPF multicenter study

Although live donor (L-D) renal transplantation represented the first broad clinical application of solid organ transplantation >20 years ago, the most dramatic changes in this area of transplantation have occurred during the past 5 years. In particular, studies dealing with two therapeutic factors have had a significant impact: confirmation that donor-specific blood transfusions (DSBT) prior to 1-haplotype match (1-HM) renal transplantation markedly improved graft survival; and the introduction of cyclosporine (CsA) use. Excellent results with DSBT in 1-HM transplantation have also led to its use with haplodistinct (O-HM) related and unrelated donors. Both DSBT and CsA currently have well-described drawbacks, the former in terms of inconvenience and risk of potential donor sensitization and exclusion prior to transplant, and the latter in terms of cost and risk of nephrotoxicity. Recent evidence suggests a comparable benefit of DSBT but decreased risk of sensitization using random blood transfusions (RBT). Because of these and several other questions regarding risk factors in L-D renal transplantation, a prospective, multicenter observational study was begun in 1982 for all L-D transplants performed by member institutions of SEOPF to address in part the specific question of cost-benefit relative to DSBT, RBT, and CsA therapy. This report provides preliminary results of this ongoing study.