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The use of procarbazine hydrochloride versus cyclophosphamide in donor pretreatment in cadaveric renal transplantation.

During a prospective study, 13 patients received renal transplants from cadaveric donors whose hearts beat up to the time of their death. These donors were pretreated with cyclophosphamide-methylprednisolone (group A) or methylprednisolone-procarbazine hydrochloride (group B). After a minimum follow-up of 12 months, all grafts in group A but only one graft in group B survived. On the basis of this small experience, the combination of cyclophosphamide and methylprednisolone seems to be superior to that of methylprednisolone and procarbazine hydrochloride in reducing allograft immunogenicity. In order to achieve longer survival of the graft in the recipient, pretreatment with procarbazine hydrochloride has been discontinued. Pretreatment of the potential cadaveric allograft donor with cyclophosphamide and methylprednisolone is being continued at our institution.