Preoperative treatment of a presensitized kidney transplant recipient with donor-derived transplant acceptance-inducing cells.
This report describes the case of patient FR, a 31-year-old recipient of a living-related kidney transplant from a donor against whom he was presensitized. Seventeen days prior to transplantation, a central venous infusion of transplant acceptance-inducing cells (TAICs) was administered to the patient. During the 27-month follow up, the patient experienced no acute rejection episodes under an immunosuppressive regime comprising anti-thymocyte globulin (ATG) induction, corticosteroids and tacrolimus. In a similar manner to the kidney transplant recipients treated preoperatively with TAICs in a previous study, patient FR achieved a state of donor-specific hypo-responsiveness. Most remarkably, the deliberate preoperative exposure of a sensitized patient to the sensitizing alloantigen did not heighten his response; on the contrary, after TAIC treatment and transplantation, HLA-specific antibodies were no longer detectable. The case of patient FR provides further evidence of the safety of pre-transplantation treatment with TAICs.
Laboratory of Transplantation Research of the Clinic of General and Thoracic Surgery, University of Schleswig-Holstein, Kiel, Germany. james.hutchinson@uksh-kiel.de
James A
JA
Hutchinson
Dave
D
Roelen
Paloma
P
Riquelme
Beate G
BG
Brem-Exner
Oliver
O
Witzke
Thomas
T
Philipp
Martina
M
Matthäi
Felix
F
Gövert
Frans H J
FH
Claas
Eckhard
E
Westphal
Ulrich
U
Kunzendorf
Edward K
EK
Geissler
Fred
F
Fändrich
D000328:Adult; D064987:Cell- and Tissue-Based Therapy; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007518:Isoantibodies / Q000032:analysis; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008264:Macrophages / Q000276:immunology*; D008297:Male; D014019:Tissue Donors; D019172:Transplantation Conditioning; D023001:Transplantation Tolerance / Q000276:immunology*
D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies