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Detecting and Treating Early Renal Homotransplant Rejection FREE

Samuel L. Kountz, MD; Donald R. Laub, MD; Roy Cohn, MD
[+] Author Affiliations

Read before the session on transplantation of the Fourth Multiple Discipline Research Forum during the 113th annual convention of the American Medical Association, San Francisco, June 24, 1964.

Reprint requests to 300 Pasteur Dr, Palo Alto, Calif (Dr. Kountz).


From the Department of Surgery, Stanford University School of Medicine, Palo Alto, Calif.


JAMA. 1965;191(12):997-1001. doi:10.1001/jama.1965.03080120031008
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The recipient of a renal transplant who is not genetically identical with the donor immediately falls victim of a new disease: renal homotransplant or renal-heterotransplant rejection. Since measures to induce specific immunologic tolerance to renal homotransplants are as yet unavailable, survival of the recipient is dependent upon effective therapy of his new disease.

The long-term results in both man and animals for experimental use whose survivals have depended on a single life-sustaining renal homotransplant have been poor.12 Some died from overdosage of the immunosuppressive drugs while the transplant exhibited good function, and others of homotransplant rejection from inadequate therapy. It has been suggested that the usual parameters of renal function were inadequate for early detection and monitoring of the immunologic reaction in renal homotransplants, especially in modified recipients.2-4 The usual dosage guide of immunosuppressive-drug therapy in renal homotransplantation has been a balance between toxicity, chiefly on the hematopoietic

REFERENCES

 Proceedings of Human Kidney Transplant Conference , Transplantation 2:147-165 ( (Jan) ) 1964;.
Alexandre, G.P.J., et al:  Immunosuppressive Drug Therapy in Canine Renal and Skin Homografts , Transplantation 1:432-461 ( (Oct) ) 1963;.
Murray, J.E., et al:  Kidney Transplantation in Modified Recipients , Ann Surg 156:337-355 ( (Sept) ) 1962;.
Hume, D.M., et al:  Renal Homotransplantation in Man in Modified Recipients , Ann Surg 158:608-644 ( (Oct) ) 1963;.
Dempster, W.J.:  Toxic Syndrome Observed in Dogs With Transplanted Kidney , Acta Med Scand 144:360, 1952;-1953.
Tyler, H.M., et al:  Trypsin Inhibitor Levels and Homograft Rejection , Clin Sci 26:315-321 ( (April) ) 1964;.
Kountz, S.L., et al:  Mechanism of Rejection of Homotransplanted Kidneys , Nature 199:257-260 ( (July) ) 1963;.
Blaufox, M.D., et al:  Simplified Method of Estimating Renal Function With Iodohippurate I131 , J Surg Res 3:122-125 ( (March) ) 1963;.
Marchioro, T.L., et al:  Role of Adrenocortical Steroids in Reversing Established Homograft Rejection , Surgery 55:412-417 ( (March) ) 1964;.
Dempster, W.J.:  Kidney Homotransplantation , Brit J Surg 40:447-465 ( (March) ) 1953;.
Starzl, T.E.; Marchioro, T.L.; and Waddell, W.R.:  Reversal of Rejection in Human Renal Homografts With Subsequent Development of Homograft Tolerance , Surg Gynec Obstet 117:385-395 ( (Oct) ) 1963;.
Reemtsma, K., et al:  Heterotransplantation of Kidney: Two Clinical Experiences , Science 143:700-702 ( (Feb) ) 1964;.

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 Proceedings of Human Kidney Transplant Conference , Transplantation 2:147-165 ( (Jan) ) 1964;.
Alexandre, G.P.J., et al:  Immunosuppressive Drug Therapy in Canine Renal and Skin Homografts , Transplantation 1:432-461 ( (Oct) ) 1963;.
Murray, J.E., et al:  Kidney Transplantation in Modified Recipients , Ann Surg 156:337-355 ( (Sept) ) 1962;.
Hume, D.M., et al:  Renal Homotransplantation in Man in Modified Recipients , Ann Surg 158:608-644 ( (Oct) ) 1963;.
Dempster, W.J.:  Toxic Syndrome Observed in Dogs With Transplanted Kidney , Acta Med Scand 144:360, 1952;-1953.
Tyler, H.M., et al:  Trypsin Inhibitor Levels and Homograft Rejection , Clin Sci 26:315-321 ( (April) ) 1964;.
Kountz, S.L., et al:  Mechanism of Rejection of Homotransplanted Kidneys , Nature 199:257-260 ( (July) ) 1963;.
Blaufox, M.D., et al:  Simplified Method of Estimating Renal Function With Iodohippurate I131 , J Surg Res 3:122-125 ( (March) ) 1963;.
Marchioro, T.L., et al:  Role of Adrenocortical Steroids in Reversing Established Homograft Rejection , Surgery 55:412-417 ( (March) ) 1964;.
Dempster, W.J.:  Kidney Homotransplantation , Brit J Surg 40:447-465 ( (March) ) 1953;.
Starzl, T.E.; Marchioro, T.L.; and Waddell, W.R.:  Reversal of Rejection in Human Renal Homografts With Subsequent Development of Homograft Tolerance , Surg Gynec Obstet 117:385-395 ( (Oct) ) 1963;.
Reemtsma, K., et al:  Heterotransplantation of Kidney: Two Clinical Experiences , Science 143:700-702 ( (Feb) ) 1964;.
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