Pretreatment of the cadaveric renal allograft donor: Beneficial effect in the high-risk patient

In recent years, the heartbeating, cadaveric renal transplant donor has been pretreated with intravenously-administered cyclophosphamide and methylprednisolone to reduce the immunogenicity of the graft. Some studies have shown that this regimen has a beneficial effect on graft survival, but others have been unable to confirm these results. Thus, a randomized, multicenter study is needed to determine whether immunologic donor pretreatment can be uniformly successful at any center. At the Mayo Clinic, results with pretreatment of the cadaveric donor continue to be better than those with no pretreatment, although our overall recent results with this regimen are less successful than our earlier experience.