title: The role of donor bone marrow infusions in withdrawal of immunosuppression in adult liver allotransplantation.
abstract: We investigated the role of donor bone marrow cell (DBMC) infusions in immunosuppression withdrawal in adult liver transplantation. Patients enrolled were at least 3 years post-transplantation, with stable graft function. Forty-five (study group: G1) received DBMC, and 59 (control group: G2) did not. Immunosuppression was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year. Patient and graft survival were similar between the two groups. Although rejection episodes were significantly less in G1 the first 2 years of the study (35% vs. 57%, p = 0.016), there was no significant difference overall (74% vs. 81%, p = 0.14). Until February 2004, 20 patients, 10 in each group, were immunosuppression free for 1-3 years. Approximately 20% of long-term survivors of liver transplantation can successfully discontinue their immunosuppression. DBMC infusions, do not increase this likelihood.
authors.affiliation: Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, Florida, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tryphonopoulos
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
authors.forename: Debbie
authors.initials: D
authors.lastname: Weppler
authors.forename: Rolando
authors.initials: R
authors.lastname: Garcia-Morales
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Juan R
authors.initials: JR
authors.lastname: Madariaga
authors.forename: David M
authors.initials: DM
authors.lastname: Levi
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: Jang
authors.initials: J
authors.lastname: Moon
authors.forename: Gennaro
authors.initials: G
authors.lastname: Selvaggi
authors.forename: Arie
authors.initials: A
authors.lastname: Regev
authors.forename: Caio
authors.initials: C
authors.lastname: Nery
authors.forename: Pablo
authors.initials: P
authors.lastname: Bejarano
authors.forename: Amr
authors.initials: A
authors.lastname: Khaled
authors.forename: Gary
authors.initials: G
authors.lastname: Kleiner
authors.forename: Violet
authors.initials: V
authors.lastname: Esquenazi
authors.forename: Joshua
authors.initials: J
authors.lastname: Miller
authors.forename: Philip
authors.initials: P
authors.lastname: Ruiz
authors.forename: Camillo
authors.initials: C
authors.lastname: Ricordi
mesh_terms: D016026:Bone Marrow Transplantation; D005260:Female; D006084:Graft Rejection / Q000628:therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D016031:Liver Transplantation; D008297:Male; D013997:Time Factors; D014019:Tissue Donors