This report examines the effect of pretransplant (pre-Tx) blood transfusions (BT) on the patioent and graft survival results of 320 cyclosporine (CsA) and prednisone (Pred)—treated primary (10) recipients of cadaveric (CAD) donor renal allografts. The 320 CsA-Pred treated 10) -CAD recipients included 100 pre-Tx untransfused (O-BT) and 220 transfused patients. The overall patient survivals at 12, 24, adn 36 months post-Tx were 94%, 94%, adn 93%, respectively. There were no differences observed in graft survivals at 12, 24, or 36 months post-Tx wherther patients received 0, 1–4,5–10 or> 10 pre-Tx BTs. A mean serum creatinine of 1.90.7 mg/dl was comparable among all BT groups at 12, 24, and 36 months post-Tx. The frequency of rejection eposodes—namely, 37% for O-BT and 36% for >O-BT were identical. High-riosk patients (>45 years of age, diabetics, or blacks) were comparably distributed in O-BT and >O-BT groups and did not impact on the data. Similarly, increasing panel-reactive antiobodies (PRA), associated with increasing numbers of pre-Tx BTs, did not influence the data. When HLA A, B, and DR matching results were combined with the BT groupings no difference were observed in patient or graft survivals. Poorly matched and untransfused recipients. These findings suggest that CsA-Pred immunosuppressive therapy allows for successful 1o-CAD renal allograft transplantation without the need for pretranplant blood transfusion conditioning or matching of donor HLA A, B, and DR antigens to recipients.