Effects of donor bone marrow infusion in clinical lung transplantation.
BACKGROUND
We have demonstrated that donor cell chimerism is associated with a lower incidence of obliterative bronchiolitis (OB) in lung recipients, and that donor chimerism is augmented by the infusion of donor bone marrow (BM). We herein report the intermediate results of a trial combining the infusion of donor BM and lung transplantation.


METHODS
Clinical and in vitro data of 26 lung recipients receiving concurrent infusion of donor bone marrow (3.0 to 6.0 x 10(8) cells/kg) were compared with those of 13 patients receiving lung transplant alone.


RESULTS
Patient survival and freedom from acute rejection were similar between groups. Of the patients whose graft survived greater than 4 months, 5% (1 of 22) of BM and 33% (4 of 12) of control patients, developed histologic evidence of OB (p = 0.04). A higher proportion (but not statistically significant) of BM recipients (7 of 10, 70%) exhibited donor-specific hyporeactivity by mixed lymphocyte reaction assays as compared with the controls (2 of 7, 28%).


CONCLUSIONS
Infusion of donor BM at the time of lung transplantation is safe, and is associated with recipients' immune modulation and a lower rate of obliterative bronchiolitis.
Pham
S M
SM
Department of Surgery, Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pennsylvania, USA. spham@exchange.med.miami.edu
Rao
A S
AS
Zeevi
A
A
McCurry
K R
KR
Keenan
R J
RJ
Vega
J D
JD
Kormos
R L
RL
Hattler
B G
BG
Fung
J J
JJ
Starzl
T E
TE
Griffith
B P
BP
D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology*; D001989:Bronchiolitis Obliterans / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D018183:Transplantation Chimera