Tolerance and chimerism after renal and hematopoietic-cell transplantation.
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.
Scandling
John D
JD
Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Busque
Stephan
S
Dejbakhsh-Jones
Sussan
S
Benike
Claudia
C
Millan
Maria T
MT
Shizuru
Judith A
JA
Hoppe
Richard T
RT
Lowsky
Robert
R
Engleman
Edgar G
EG
Strober
Samuel
S
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