SMALL-BOWEL TRANSPLANTATION - THE EFFECT OF INTRAPORTAL DONOR-SPECIFIC TRANSFUSION 24 HOURS PRETRANSPLANT AND LOW-DOSE CYCLOSPORINE

We tested the synergy of donor-specific transfusion (DST) and cyclospo rine (CsA) in small bowel transplantation by comparing the systemic ve rsus portal route of DST administration in a fully allogeneic rat mode l. The protocol is relevant to cadaveric transplantation by conditioni ng only 24 hr before allografting. A 1 ml intraportal DST day -1 and l ow-dose CsA significantly prolonged survival (MST 53.7+/-17.5 days) wh en compared with systemic DST day -1 and low-dose CsA (MST 18.4+/-5.6 days). This suggests that intraportal DST can be beneficial in cadaver ic SBT, as only a 24-hr induction period is necessary. We speculate th at antigen trapping in the liver and interaction of the DST with Kupff er cells is central to the portal DST effect.