Bone marrow transfusions in cadaver renal allografts: pilot trials with concurrent controls.
BACKGROUND
The safety and immune tolerance potential of donor marrow infusion with cadaveric source renal transplants was evaluated in a series of non-randomized multicenter pilot trials by the NIH Cooperative Clinical Trials in Transplantation (CCTT) Group.


METHODS
Three strategies were tested: (1) immunosuppression with cyclosporin, azathioprine and prednisone with a single post-transplant day 1 infusion of 5 x 107 viable cells/kg, (2) OKT3 induction with triple drug therapy and marrow transfusion on day 1, or (3) same therapy as (2) but with an additional marrow transfusion on day 10-12.


RESULTS
Thirty-eight marrow recipients and 35 contemporaneous controls were entered with a mean follow-up of over 5 yr. Graft survival was initially better in the marrow recipients than the controls but was similar after 5 yr. Microchimerism rates were similar for the marrow infusion and control groups throughout the follow-up period, regardless of the immunosuppression strategies.


CONCLUSIONS
Bone marrow infusions were well tolerated by a group of cadaver renal allograft recipients. There were no complications from the infusion(s), no episodes of graft-vs.-host disease (GVHD) and no increase in infections or other complications. There was a trend toward early improved graft survival in marrow recipients. Decreased rejection rates were observed in black recipients.
Light
Jimmy
J
Transplant Services, Washington Hospital Center, Washington, DC 20010, USA.jimmy.a.light@medstar.net
Salomon
Daniel R
DR
Diethelm
Arnold G
AG
Alexander
J Wesley
JW
Hunsicker
Lawrence
L
Thistlethwaite
Richard
R
Reinsmoen
Nancy
N
Stablein
Donald M
DM
D016026:Bone Marrow Transplantation; D002102:Cadaver; D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D015337:Multicenter Studies as Topic; D016853:Muromonab-CD3 / Q000627:therapeutic use; D012189:Retrospective Studies; D018183:Transplantation Chimera; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents; D016853:Muromonab-CD3