title: Facilitating cells in tolerance induction for kidney transplantation.
abstract: OBJECTIVE
  To describe the clinical outcomes and science behind a CD8/TCR facilitating cell-based hematopoietic stem cell transplant approach (termed FCRx) to induce tolerance to renal allografts without graft-versus-host disease (GVHD) and avoidance of long-term immunosuppressant drugs in living donor kidney transplant recipients.
  
  
  RESULTS
  Successful solid organ transplantation currently requires the life-long use of medications to suppress the immune system to prevent transplant rejection. Drug-based immunosuppression significantly increases the risk of infection and cancer, as well as being very costly. Development of new therapies to minimize or eliminate entirely the need for antirejection drugs is of great interest to the transplant community. Therapeutic cell transfer for the control of the human immune system represents a compelling approach to reduce or eliminate the need for antirejection drugs.
  
  
  CONCLUSIONS
  Establishment of durable hematopoietic macrochimerism under nonmyeloablative conditioning is achievable in mismatched recipients using facilitating cells and stem cells obtained from donor mobilized peripheral blood mononuclear cells. Persistently chimeric recipients developed donor-specific tolerance and were weaned off of immunosuppressive drugs over 12 months. They maintained stable renal function without development of acute or chronic GVHD.
authors.affiliation: aInstitute for Cellular Therapeutics, University of Louisville, Louisville, Kentucky bComprehensive Transplant Center, Northwestern Memorial Hospital, Chicago, Illinois cRegenerex, LLC, Louisville, Kentucky, USA *Dr. Esma S. Yolcu and Dr. Joseph R. Leventhal contributed equally to the writing of this article.
authors.forename: Esma S
authors.initials: ES
authors.lastname: Yolcu
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Leventhal
authors.forename: Suzanne T
authors.initials: ST
authors.lastname: Ildstad
mesh_terms: D000818:Animals; D006084:Graft Rejection / Q000276:immunology*; D006086:Graft vs Host Disease / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D016030:Kidney Transplantation