[Effects of donor-specific bone marrow cell infusion on chimerism and acute rejection in kidney transplantation].
OBJECTIVE
To evaluate the effect of donor-specific bone marrow cell infusion on the production of chimerism and acute rejection in kidney transplantation.


METHODS
Sixty-one patients, 48 males and 13 females, aged 38.4 (23 - 45), underwent transplantation of cadaveric kidneys, 24 of which underwent kidney transplantation combined with donor-specific bone marrow cell infusion and 37 of which underwent pure transplantation of kidney. During the kidney transplantation combined with donor-specific bone marrow cell infusion the donor bone marrow cells (DBMC) were isolated from the thoracic vertebrae and iliac bones of the donors-cadavers and infused into the recipients of the kidneys of the same donors. After operation the peripheral blood was collected from the 61 recipients every 2 - 3 months for at least 1 year to undergo PCR to detect the presence of chimerism, and the rates of chimerism and acute rejection were compared between these 2 groups.


RESULTS
During the follow-up the presence rate of chimerism was 87.5% (21/24) in the marrow recipients, significantly higher than that in the control group (40.5%, 15/37, P < 0.001). The prevalence of acute rejection in the chimerism positive patients was 19.4% (7/16), significantly lower than that in the chimerism negative patients (44%, 11/25, P < 0.05).


CONCLUSIONS
Donor-specific bone marrow cell infusion in cadaver kidney transplantation induces the production of chimerism, and increases the immune tolerance to the donor organs, thus finally decreasing the incidence of acute rejection. Chimerism is correlated with immune tolerance.
Fu
Yao-wen
YW
Department of Urology, China-Japan Union Hospital of Jilin University, Changchun 130031, China.
Wang
Wei-gang
WG
Zhou
Hong-lan
HL
Zhang
Wen-lan
WL
Yang
Shao-juan
SJ
Wang
Jin-guo
JG
D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods; D046528:Chimerism; D002681:China / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007108:Immune Tolerance; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged