Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation.
We have previously postulated that donor cell chimerism in organ transplantation is needed to attain a tolerant state. Here we show that donor cell chimerism can be augmented in organ recipients if they are infused perioperatively with 3 x 10(8) per kg of unmodified donor bone marrow cells and are kept on a conventional immunosuppressive regimen of tacrolimus (FK506) and prednisolone. 36 patients took part, of whom the first 18 patients have good transplanted kidney (n = 10), liver (n = 7), and heart (n = 7) function when followed up between 4 and 16 months. All patients are well. We found persistent multilineage leucocyte chimerism in blood of 17 recipients by flow cytometry and PCR techniques to detect donor alleles or Y chromosomes in female recipients of male organs. The use of the 5-antigben HLA matched same sex donor precluded detection of chimerism in one patient.
Fontes
P
P
Department of Surgery, Pittsburgh Transplant Institute, University of Pittsburgh Medical Centre, PA 15213.
Rao
A S
AS
Demetris
A J
AJ
Zeevi
A
A
Trucco
M
M
Carroll
P
P
Rybka
W
W
Rudert
W A
WA
Ricordi
C
C
Dodson
F
F
D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival / Q000276:immunology*; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D018183:Transplantation Chimera / Q000276:immunology*; D014181:Transplantation Immunology