title: Tolerance and chimerism after renal and hematopoietic-cell transplantation.
abstract: We describe a recipient of combined kidney and hematopoietic-cell transplants from an HLA-matched donor. A post-transplantation conditioning regimen of total lymphoid irradiation and antithymocyte globulin allowed engraftment of the donor's hematopoietic cells. The patient had persistent mixed chimerism, and the function of the kidney allograft has been normal for more than 28 months since discontinuation of all immunosuppressive drugs. Adverse events requiring hospitalization were limited to a 2-day episode of fever with neutropenia. The patient has had neither rejection episodes nor clinical manifestations of graft-versus-host disease.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Scandling
authors.forename: Stephan
authors.initials: S
authors.lastname: Busque
authors.forename: Sussan
authors.initials: S
authors.lastname: Dejbakhsh-Jones
authors.forename: Claudia
authors.initials: C
authors.lastname: Benike
authors.forename: Maria T
authors.initials: MT
authors.lastname: Millan
authors.forename: Judith A
authors.initials: JA
authors.lastname: Shizuru
authors.forename: Richard T
authors.initials: RT
authors.lastname: Hoppe
authors.forename: Robert
authors.initials: R
authors.lastname: Lowsky
authors.forename: Edgar G
authors.initials: EG
authors.lastname: Engleman
authors.forename: Samuel
authors.initials: S
authors.lastname: Strober
mesh_terms: D003131:Combined Modality Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology; D018183:Transplantation Chimera / Q000276:immunology*; D019172:Transplantation Conditioning; D014181:Transplantation Immunology; D023001:Transplantation Tolerance / Q000276:immunology*; D014184:Transplantation, Homologous