title: Safety and efficacy of autologous mesenchymal stromal cells transplantation in patients undergoing living donor kidney transplantation: a pilot study.
abstract: OBJECTIVE
  This pilot study assesses the safety and feasibility of autologous mesenchymal stromal cell (MSC) transplantation in four patients that underwent living donor renal transplantation, and the effect on the immunophenotype and functionality of peripheral T lymphocytes following transplantation.
  
  
  METHODS
  All patients received low dose ATG induction followed by calcineurin inhibitor-based triple drug maintenance immunosuppression. Autologous MSCs were administered intravenously pre transplant and day 30 post-transplant. Patients were followed up for 6 months. The frequency of regulatory T cells and T cell proliferation was assessed at different time points.
  
  
  RESULTS
  None of the four patients developed any immediate or delayed adverse effects following MSC infusion. All had excellent graft function, and none developed graft dysfunction. Protocol biopsies at 1 and 3 months did not reveal any abnormality. Compared to baseline, there was an increase in the CD4 + CD25+FOXP3+ regulatory T cells and reduction in CD4 T cell proliferation.
  
  
  CONCLUSIONS
  We conclude that autologous MSCs can be used safely in patients undergoing living donor renal transplantation, lead to expansion of regulatory T cells and decrease in T cell proliferation. Larger randomized trials studies are needed to confirm these findings and evaluate whether this will have any impact on immunosuppressive therapy.
authors.affiliation: Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Chetan
authors.initials: C
authors.lastname: Mudrabettu
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
authors.forename: Aruna
authors.initials: A
authors.lastname: Rakha
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Yadav
authors.forename: Raja
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Deepesh B
authors.initials: DB
authors.lastname: Kanwar
authors.forename: Ritambhra
authors.initials: R
authors.lastname: Nada
authors.forename: Mukut
authors.initials: M
authors.lastname: Minz
authors.forename: Vinay
authors.initials: V
authors.lastname: Sakhuja
authors.forename: Neelam
authors.initials: N
authors.lastname: Marwaha
authors.forename: Vivekanand
authors.initials: V
authors.lastname: Jha
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects; D010865:Pilot Projects; D013601:T-Lymphocytes; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: T regulatory cell; immunomodulation; mesenchymal stromal cell; renal transplant