title: [Immunomodulation after combined spleen and kidney transplantation in swine].
abstract: 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.
authors.affiliation: Università degli Studi di Pavia, Pavia, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Rademacher
authors.forename: L
authors.initials: L
authors.lastname: Cansolino
authors.forename: S
authors.initials: S
authors.lastname: Crespi
authors.forename: L M
authors.initials: LM
authors.lastname: Lenti
authors.forename: E
authors.initials: E
authors.lastname: Lillo
authors.forename: I
authors.initials: I
authors.lastname: Tubazio
authors.forename: O
authors.initials: O
authors.lastname: Oldani
authors.forename: L
authors.initials: L
authors.lastname: Passalia
authors.forename: M
authors.initials: M
authors.lastname: Maestri
authors.forename: A
authors.initials: A
authors.lastname: Gaspari
authors.forename: P
authors.initials: P
authors.lastname: Dionigi
mesh_terms: D000818:Animals; D005260:Female; D007165:Immunosuppression Therapy / Q000379:methods*; D016030:Kidney Transplantation / Q000473:pathology; D008297:Male; D013154:Spleen / Q000473:pathology / Q000637:transplantation*; D013552:Swine