The role of donor bone marrow infusions in withdrawal of immunosuppression in adult liver allotransplantation.
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was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year.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.
Tryphonopoulos
Panagiotis
P
Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, Florida, USA.
Tzakis
Andreas G
AG
Weppler
Debbie
D
Garcia-Morales
Rolando
R
Kato
Tomoaki
T
Madariaga
Juan R
JR
Levi
David M
DM
Nishida
Seigo
S
Moon
Jang
J
Selvaggi
Gennaro
G
Regev
Arie
A
Nery
Caio
C
Bejarano
Pablo
P
Khaled
Amr
A
Kleiner
Gary
G
Esquenazi
Violet
V
Miller
Joshua
J
Ruiz
Philip
P
Ricordi
Camillo
C
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