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Manipulation of allograft immunogenicity by pretreatment of cadaver donors.

The experimental basis forming the rationale for the reduction of allograft immunogenicity prior to transplantation is described. This is based on the hypothesis that ""passenger leucocytes'' are a major immunogenic stimulus in rejection. Donor pretreatment with high doses of methylprednisolone and cyclophosphamide can be used clinically for cadaver donor pretreatment and when combined with an adequate post-transplant chemical immunosuppressive regimen results in an important in improvement in overall results as seen in a series followed for 5 1/2 years.