Use of culture and temporary immunosuppression to prolong adrenal cortical allograft survival.

Life-long corticosteroid replacement therapy is today the only form of treatment for adrenal insufficiency. The transplantation of adrenal cortical tissue could represent a more physiological approach to the treatment of this syndrome. Successful experimental transplantation of other endocrine tissues across major histocompatibility barriers encouraged us to attempt similar approaches with the adrenal cortex. Recipient rats received bilateral adrenalectomy, followed by the implantation of adrenal cortical tissue beneath the renal capsule. The tissue was transplanted either immediately after its isolation or after pretreatment with 1 week of culture (either at 24 C or in the presence of 95% oxygen). The results show that 1 week of culture of the donor tissue followed by short term treatment of the recipients with cyclosporine A allows long term (30 days) survival of the transplanted adrenal cortical tissue in all animals.