HUMAN RENAL ALLOTRANSPLANTATION AND THYMECTOMY

概要

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Strong evidence that thymectomy in adult animals caused a slowly devel oping loss in immunologic reactivity, possible relationship of the thymus to rejection of allografts and adaptability of thymectomy via the suprasternal notch to patients in poor surgical risks made it likely that the thymectomy would be employed in addition to standard immunosuppressive therapy in the treatment of patients receiving allografts. The course of six patients was studied after renal allotransplantation from related donors. Transcervical thymectomy was performed after transplantation in three patients and before transplantation in the other three recipients. While some fractions of im munoglobulins increased or decreased after transplantation in the non-thy mectomized patients, immunoglobulin levels did not. change at all before and after transplantation in the patients in whom thymectomy had been carried out before renal allotransplantation. Pathologic studies with light microscopy revealed that the thymuses of patients who received thymectomy after allo transplantation did not lack the cortex on prednisolone therapy for 557 to 967 days. In one patient, lymphocytes in urinary sediment disappeared following thymectomy. The results suggest that thymectomy may merit further con sideration with regard to its possible usefulness as immunosuppressive treat ment in renal allotransplantation.
The Keio Journal of Medicineの論文