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March 1968

Treatment of Renal Allograft Rejection in Dogs: Combined Thoracic Duct Fistula and Immunosuppressive Chemotherapy

Author Affiliations

From the Department of Surgery, Hahnemann Medical College, Philadelphia.

Arch Surg. 1968;96(3):344-348. doi:10.1001/archsurg.1968.01330210022005

A previous study in this laboratory suggested that an external thoracic duct fistula could prolong the survival of canine renal allografts.1 The mechanism for this apparent interference with the transplant immunity might be the depletion in the population of immunologically competent lymphocytes resulting from uninterrupted drainage of the thoracic duct. Gowans has shown that lymphopenia can be brought about by prolonged drainage of the thoracic duct in rats.2 Others have reported similar findings in dogs.3

Although the role of the lymphocytes in transplant immunity has not been ascertained, it seems only reasonable to implicate them because of their consistent involvement in the antigen-antibody reaction. Their well documented presence at the site of the tissue graft rejection marks them teleologically as an intermediary in this phenomenon, specifically as carriers of antibodies. For this reason immunosuppressive drugs have been tested according to their ability to produce lymphopenia. Even some