title: Co-infusion of donor adipose tissue-derived mesenchymal and hematopoietic stem cells helps safe minimization of immunosuppression in renal transplantation - single center experience.
abstract: BACKGROUND
  Stem cell therapy (SCT) is used for immunosuppression minimization in renal transplantation (RT). We carried out a prospective study to evaluate the benefits of co-infusion of donor adipose-derived mesenchymal stem cells (AD-MSC) + hematopoietic stem cells (HSC) in living donor RT (LDRT) under non-myeloablative conditioning.
  
  
  METHODS
  In a demographically balanced three-armed LDRT trial with 95 patients in each arm, group-1 received portal co-infusion of AD-MSC + HSC, group-2 received HSC and group-3 received no SCT. Lymphoid irradiation and anti-thyroglobulin were used for conditioning.
  
  
  RESULTS
  SCT was safe. At 1 and 5 years post-transplant, patient survival was 100% and 94.7% in group-1, 100% and 95.7% in group-2, and 94.7% and 84% in group-3, death-censored graft survival was 100% and 94.6% in group-1, 100% and 91.3% in group-2, and 98.9% and 94.4% in group-3 with mean serum creatinine (mg/dL) of 1.38 and 1.39 in group-1, 1.48 and 1.51 in group-2, and 1.29 and 1.42 and in group-3. Rejection episodes and immunosuppression requirement were lesser in SCT groups versus controls with best results noted in group-1.
  
  
  CONCLUSIONS
  Coinfusion of donor AD-MSC +HSC in portal circulation pre-transplant under non-myeloablative conditioning is safe and effective for immunosuppression minimization in LDRT.
authors.affiliation: Department of Pathology, Laboratory of Medicine, Transfusion Services and Immunohematology, G. R. Doshi and K. M. Mehta Institute of Kidney Diseases & Research Centre (IKDRC), Dr. H.L. Trivedi Institute of Transplantation Sciences (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: Ashutosh
authors.initials: A
authors.lastname: Kumar
authors.forename: Saroj Chooramani
authors.initials: SC
authors.lastname: Gopal
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.forename: Manoj R
authors.initials: MR
authors.lastname: Gumber
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.forename: Shruti D
authors.initials: SD
authors.lastname: Dave
mesh_terms: D000273:Adipose Tissue / Q000166:cytology*; D000328:Adult; D000368:Aged; D001323:Autoantibodies; D005260:Female; D005434:Flow Cytometry; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin
keywords: Adipose tissue-derived mesenchymal stem cells; hematopoietic stem cells; minimization of immunosuppression; rejection; renal transplantation