title: Pre-transplant co-infusion of donor-adipose tissue derived mesenchymal stem cells and hematopoietic stem cells may help in achieving tolerance in living donor renal transplantation.
abstract: Transplantation tolerance is still a Utopian dream for many transplanters. Mesenchymal stem cells (MSC) have shown immuno-modulatory and tolerogenic effects in experimental models. We present a 29-year-old male with end stage renal disease (ESRD) who was transplanted with HLA 4/6 matched kidney from 51-year-old father in June 2010 preceded by co-infusion of donor-adipose tissue derived mesenchymal stem cells (AD-MSC) and bone marrow derived hematopoietic stem cells (BM-HSC) under non-myeloablative conditioning for deleting rejecting T and B-cells. He has maintained fairly stable graft function with serum creatinine (SCr) between 1.5 and 1.8 mg/dL at 3 years post-transplant with absence of donor specific antibodies (DSA), normal protocol graft biopsy, and peripheral T-regulatory cell levels (pTregs) (CD127(low/-)CD25(high)CD4+) of 4.57% on zero immunosuppression since 6 months.
authors.affiliation: Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, Gujarat , India .
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
authors.forename: Saroj Chooramani
authors.initials: SC
authors.lastname: Gopal
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Kumar
authors.forename: Shruti D
authors.initials: SD
authors.lastname: Dave
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000328:Adult; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D019172:Transplantation Conditioning / Q000379:methods*; D023001:Transplantation Tolerance