D. D. JOEL AND E. P. CRONKITE 
895 
ANTERIOR 
SKIN ALLOGRAFTS 
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J 
AFFERENT 
LYMPHATICS 
TO 
REGIONAL 
LYMPH NODE 
LEFT BRACHIAL 
LYMPH DUCT 
POSTERIOR 
SKIN ALLOGRAFTS 
© 
© 
0 
© 
© 
© 
© 
© 
© 
AFFERENT 
LYMPHATICS 
TO 
REGIONAL 
LYMPH NODE 
THORACIC DUCT 
CANNULA 
Figure 7. — This diagrammatic sketch shows the probable anatomical pathways of committed lymphocytes from 
the lymph nodes draining anterior and posterior skin allografts. Cannulation of the thoracic duct leaves the 
flow of lymph from the left brachial duct into the venous confluence uninterrupted. In the absence of any lym- 
phaticovenuos communications, it is possible by the creation of a thoracic duct-venous shunt to irradiate all of 
the committed lymphocytes from the regional lymph nodes draining the site of posterior skin allografts. (Re- 
printed from Chanana et al., Transplantation 7:459, 1969.) 
lymphatics, i.e., they do not enter the blood 
directly within the lymph node. Transit doses 
employed in this series of experiments varied 
between 350 and 1,800 rads. 
Table I. — Effect of Extracorporeal Irradiation of 
Thoracic Duct Lymph (ECIL) on the Survival of Skin 
Allografts in Calves. 
Calf 
Duration (Days) of ECIL Day of Graft Rejection 
Pregraft 
Postgraft 
Anterior 
Posterior 
12 control 
0 
0 
8-11 
203 
0 
0 
10 
10 
186 
?.2 
0 
17 
239 
10 
0 
18 
18 
200 
7 
27 
22 
39 
202 
7 
61 
27 
61* 
206 
0 
25 
13 
28 
257 
0 
21 
26 
296 
0 
28 
37 
295 
0 
11 
16 
♦ Died of acute septicemia on day 61. Grafts were intact at time 
of death. (Reprinted from Joel et al., 1967) 
Renal Allografts 
More recently we have been interested in the 
effect of ECIB on renal allograft survival. Be- 
cause of cost, availability and size, goats were 
used instead of calves. These studies are de- 
signed to: (1) determine the effectiveness of 
ECIB alone in prolonging renal allograft re- 
jection, (2) determine the most effective sched- 
ules of ECIB, and (3) study the combination 
of ECIB and standard immunosuppressive drug 
therapy. These investigations were prompted 
by the fact that, even though ECIB is already 
being used in a number of hospitals as an ad- 
junct to drug induced immunosuppression, no 
controlled animal experiments have been com- 
pleted. 
To date essentially three schedules of ECIB 
have been studied.^^ The first schedule included 
