Induction of donor specific unresponsiveness by combined treatment with donor bone marrow cell infusion, and FK506 in cadaveric renal allotransplantation.

我们成功地延长了组织不相容性比格犬骨髓供体的皮肤和肾脏移植物，通过术前分次淋巴照射（FLI），肾移植前不久从肾供体的骨髓细胞（BMC）输注，以及短期给予小剂量的免疫抑制剂FK 506的联合治疗。为了将该方法应用于尸体肾移植，我们对以下几个方面进行了研究：首先，我们用11个SSO探针建立了DLA-DNA分型方法，获得了相同的DLA错配对。第二，术中用自制冰水系统广泛冷却供肾，直至血运重建，可明显改善保存3天的供肾移植效果。第三，我们对术后免疫抑制进行了如下调整：肌肉注射FK 506，剂量为0.16mg/kg/d，共14天，然后是0.08mg/kg/d，共14天，然后继续给予0.04mg/kg/d，直到术后90天。事实上，通过这些处理，同种异体保存肾移植的存活率已大大提高。然后，研究了移植时FLI和BMC输注联合治疗的效果。

We succeeded in the prolongation of skin and kidney allografts from bone marrow donors in histoincompatible beagle dogs by combined treatment with preoperative fractionated lymphoid irradiation (FLI) , bone marrow cell (BMC) infusion from the kidney donors shortly before kidney grafting, and shortterm administration of small doses of immunosuppressant, FK506. To apply this protocol to the cadaveric renal transplantation, we have investigated the several points as fllows ; First, we established the DLA-DNA typing using ll SSO probes by the method of PCR-SSO typing by which the same DLA mismatched pairs were obtained. Second, the results of allografting of 3-days preserved kidneys was remarkably improved by extensively cooling the transplants with ice-water system made by ourselves until revascularization in the course of operation. Third, we adapted the postoperative immunosuppression as follows ; i.m.administration of FK506 at the dose of 0.16mg/kg/d for 14 days, followed by 0.08mg/kg/d for 14 days, then continued to give the dose of 0.04mg/kg/d until 90 days postoperatively. In fact, by these treatment the survival rate of allografted preserved kidneys have been greatly improved. Then, the effect of combined treatment with FLI,and, BMC infusion at the time of grafting has been under investigation.