Photochemical Donor Pretreatment in Clinical Kidney Transplantation—Preliminary Report

Extended experimental experience with the efficiacy of pretreating the kidney donor and the allograft by means of photochemotherapy (photosensitizer+UVA irradiation=PUVA) was adopted in clinical kidney transplantation. In a preliminary unrandomized study similar patient populations were treated by generally uniform methods. Thirty-three PUVA-pretreated kidneys (group A) were compared with the experience regarding 26 nonpretreated kidney allografts (group B). The number of rejection episodes was significantly lower in the first 3 months in group A (p< 0.05 vs group B) and fewer grafts failed because of irreversible rejection (2 vs 5). Furthermore, in group A the rate of infectious complications was lower (18% vs 34%). The cumulative allograft survival at 3 months was improved from 65% in group B to 81% in group A and at 12 months from 65% 76%, respectively. These differences were not significant. Therefore, our preliminary clinical experience with a photochemical donor pretreatment is encouraging and further use in a randomized study seems to be necessary.