title: Skin transplantation to monitor clinical donor-related tolerance in mixed hematopoietic chimerism.
abstract: Mixed hematopoietic chimerism usually carries with it the tolerance to any other tissue from the same donor. Consequently, the establishment of a sustained chimerism may allow long-term acceptance of transplanted organs without immunosuppression. We report a girl with refractory severe aplastic anemia who developed low recipient level hematopoietic chimerism following transplantation of maternal highly purified CD34+ cells without prophylactic immunosuppression. Renal thrombotic microangiopathy led to chronic renal failure and she received skin allografts from her mother in view of a future kidney donation. The maternal skin grafts were accepted without immunosuppression and the hematopoietic chimerism remained stable. Skin transplantation may be a helpful and easily applicable tool to monitor donor-related tolerance in hematopoietic chimerism clinically. It should contribute to minimize the risks of subsequent solid organ transplantation from the same donor without immunosuppression.
authors.affiliation: Department of Pediatrics, Medical University Graz, Graz, Austria. christoph.mache@meduni-graz.at
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Mache
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schwinger
authors.forename: Stephan
authors.initials: S
authors.lastname: Spendel
authors.forename: Otto
authors.initials: O
authors.lastname: Zach
authors.forename: Sigrid
authors.initials: S
authors.lastname: Regauer
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Ring
mesh_terms: D000741:Anemia, Aplastic / Q000601:surgery*; D002648:Child; D046528:Chimerism; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000235:genetics*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D008991:Monitoring, Physiologic / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*