title: Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation.
abstract: 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.
authors.affiliation: Department of Surgery, Pittsburgh Transplant Institute, University of Pittsburgh Medical Centre, PA 15213.
authors.forename: P
authors.initials: P
authors.lastname: Fontes
authors.forename: A S
authors.initials: AS
authors.lastname: Rao
authors.forename: A J
authors.initials: AJ
authors.lastname: Demetris
authors.forename: A
authors.initials: A
authors.lastname: Zeevi
authors.forename: M
authors.initials: M
authors.lastname: Trucco
authors.forename: P
authors.initials: P
authors.lastname: Carroll
authors.forename: W
authors.initials: W
authors.lastname: Rybka
authors.forename: W A
authors.initials: WA
authors.lastname: Rudert
authors.forename: C
authors.initials: C
authors.lastname: Ricordi
authors.forename: F
authors.initials: F
authors.lastname: Dodson
mesh_terms: 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