The thoracic duct fistula has been tested as an ancillary method of immune suppression in 20 human recipients of renal allografts. Eleven patients drained over 10 liters of lymph and over 20 X 109 lymphocytes. A persistent peripheral lymphocytopenia appeared concomitantly. Nine patients with poorly functioning or attempted fistulae who drained less than that amount served as a control group. Rejection crises among those with well functioning fistulae were fewer and of later onset following transplantation than in the control patients. Lymphocyte depletion through chronic thoracic duct drainage is proffered as a nontoxic and acceptable adjunct to current methods of immunosuppression. Experimental support of this concept is discussed.
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Tilney et al. (1967) studied this question.