Beneficial Effect of Pre-Transplant Splenectomy for Leukopenia in Primary Cadaver Kidney Transplants

Barry, John M.
Larson, Betty
Fischer, Susan M.
Norman, Douglas J.
Bennett, William M.

From the Divisions of Urology and Nephrology, Oregon Health Sciences University, Portland, Oregon

^*Requests for reprints: Division of Urology, Oregon Health Sciences University, Portland, Oregon 97201.

Accepted July 9, 1982.

Journal of Urology 129(3):p 478-480, March 1983. | DOI: 10.1016/S0022-5347(17)52190-4

ABSTRACT

Pre-transplant splenectomy is controversial. We compared 21 nondiabetic, transfused recipients of first cadaver kidney grafts who underwent pre-transplant splenectomy for steroid-resistant leukopenia to 114 without steroid-resistant leukopenia. Kidney graft survivals at 2 years were 80.2 plus or minus 8.9 and 48.5 plus or minus 5.3 per cent, respectively (p <0.05). The 2-year actuarial patient survivals were not significantly different (89.6 plus or minus 7.0 versus 87.8 plus or minus 3.9 per cent). Azathioprine doses and serum creatinine levels at 1 year were not significantly different. Pretransplant splenectomy for steroid-resistant leukopenia resulted in a significant decrease in kidney graft losses owing to rejection without an increased risk of death of sepsis or thromboembolism.