The Immunosuppressive Effect of Thoracic Duct Drainage in Human Kidney Transplantation

Lymphocyte depletion through chronic thoracic duct fistulae in patients receiving scheduled renal allografts from genetically related donors is reviewed, and these patients are compared to others undergoing transplantation within a similar period. Clinical and statistical examination shows consistantly superior allograft performance and survival as long as 53 months after transplantation. The number and severity of rejection crises occurring within the transplantation period were significantly diminished in the lymphocytopenic host. No increased incidence of sepsis was found among those with lymphocyte drainage. Four fistula wounds of the 41 created in the series became infected. This postponed scheduled transplantation in three patients. Chronic thoracic duct drainage is effective and safe in decreasing the immunologic response of the recipient of renal transplants from genetically related donors.