Chimerism and donor-specific nonreactivity 27 to 29 years after kidney allotransplantation.
Chimerism was demonstrated with immunocytochemical and/or polymerase chain reaction techniques in kidney allografts and in the native skin, lymph nodes, or blood of 5 of 5 patients who received continuously functioning renal transplants from 1 or 2 haplotype HLA mismatched consanguineous donors (4 parents, 1 aunt) 27-29 years ago. In the 4 cases where the kidney donor still was alive to provide stimulator lymphocytes for testing, these provoked no (n = 2) or modest (n = 2) MLR in contrast to vigorous MLR to third party lymphocytes. In all 4 cases, the donor cells failed to generate in vitro cytotoxic effector cells (cell-mediated lymphocytotoxicity). These findings are in accord with the hypothesis that cell migration, repopulation, and chimerism are seminal events that define graft acceptance and ultimately can lead to acquired donor-specific nonresponsiveness (tolerance).
Starzl
T E
TE
Pittsburgh Transplant Institute, Pennsylvania.
Demetris
A J
AJ
Trucco
M
M
Zeevi
A
A
Ramos
H
H
Terasaki
P
P
Rudert
W A
WA
Kocova
M
M
Ricordi
C
C
Ildstad
S
S
D000328:Adult; D002678:Chimera; D005260:Female; D006085:Graft Survival; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007108:Immune Tolerance; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology*; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D016133:Polymerase Chain Reaction; D013997:Time Factors
D006684:HLA-DR Antigens