Endothelial cell chimerism does not influence allograft tolerance in liver transplant patients after withdrawal of immunosuppression.
BACKGROUND
Human liver allografts sometimes show self-induced permanent tolerance without immunosuppression. It has recently been proposed that the replacement of liver donor endothelial cells by recipient cells could confer a survival advantage. The aim of this study was to analyze liver endothelial cell replacement in relation to the response (tolerance or rejection) after withdrawal of immunosuppression in liver transplant patients.


METHODS
Nine liver recipient patients were entered into a program of immunosuppressive drug withdrawal. The authors studied liver endothelial cell chimerism in five of these patients who received a liver from a donor of the opposite sex by in situ hybridization for X and Y chromosomes.


RESULTS
Three patients (33%) achieved complete withdrawal of immunosuppression. The authors' data show similar endothelial cell chimerism in both the tolerant and nontolerant patients analyzed.


CONCLUSIONS
Endothelial cell chimerism has nothing to do with the induction of clinical tolerance in liver transplant patients after withdrawal of immunosuppression.
Pons
José A
JA
Transplant Unit, Department of Surgery, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena s/n, El Palmar, 30120-Murcia, Spain. japons@mixmail.com
Yélamos
José
J
Ramírez
Pablo
P
Oliver-Bonet
María
M
Sánchez
Alicia
A
Rodríguez-Gago
Manolo
M
Navarro
Joaquima
J
Bermejo
Juan
J
Robles
Ricardo
R
Parrilla
Pascual
P
D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage*; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008102:Liver Circulation; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018183:Transplantation Chimera; D023001:Transplantation Tolerance; D014680:Veins
D007166:Immunosuppressive Agents; D016572:Cyclosporine