[Immunomodulation after combined spleen and kidney transplantation in swine].
OBJECTIVE
Organ transplantation is the most effective treatment for several degenerative end-stage diseases. While the mainstream immunosuppression can achieve satisfactory results, the therapy has either side effects and flaws. The golden target to reach should be a stable tolerance with the transplanted organ accepted without a long term drug administration. Recent studies demonstrated a tolerogenic effect of spleen cells. Aim of this study is to evaluate a model of combined spleen and whole organ transplantation in a significant preclinical setting in swine.


METHODS
Twenty-five outbred Landrace/Large-White swine underwent combined spleen/kidney transplantation (SKTx). The experiments were stratified into 3 groups per randomization. Group 1 (N=7) received kidney transplantation (KTx) alone with no immunosuppressive treatment. Group 2 (N=9) had a combined KTx and whole graft spleen Tx. Group 3 (N=9) had KTx and spleen cells (DST), injected through the portal vein. Renal lab tests were collected to evaluate the onset of rejection. Survivals were evaluated as well. The end-point of the study was at onset of kidney failure or at the limit of 60 postoperative day (POD) in non-rejecting animals. Tissue samples were collected to evaluate grade and severity of rejection.


RESULTS
Controls died from kidney failure within 10(th) POD. Group 2 and 3, had a delayed renal graft rejection and an overall prolonged graft survival. Whole graft and spleen cells injection share this effect, while spleen administration through the portal route proved a superior effect, which is significant compared to controls (Kaplan Meier survival analysis P<0.05).


CONCLUSIONS
These results, from a non immunosuppressed setting, suggest that spleen plays a key role as an immunomodulatory organ.
Rademacher
J
J
Università degli Studi di Pavia, Pavia, Italy.
Cansolino
L
L
Crespi
S
S
Lenti
L M
LM
Lillo
E
E
Tubazio
I
I
Oldani
O
O
Passalia
L
L
Maestri
M
M
Gaspari
A
A
Dionigi
P
P
D000818:Animals; D005260:Female; D007165:Immunosuppression Therapy / Q000379:methods*; D016030:Kidney Transplantation / Q000473:pathology; D008297:Male; D013154:Spleen / Q000473:pathology / Q000637:transplantation*; D013552:Swine