title: Macrochimerism in Intestinal Transplantation: Association With Lower Rejection Rates and Multivisceral Transplants, Without GVHD.
abstract: Blood chimerism has been reported sporadically among visceral transplant recipients, mostly in association with graft-vs-host disease (GVHD). We hypothesized that a higher degree of mixed chimerism would be observed in multivisceral (MVTx) than in isolated intestinal (iITx) and isolated liver transplant (iLTx) recipients, regardless of GVHD. We performed a longitudinal prospective study investigating multilineage blood chimerism with flow cytometry in 5 iITx and 4 MVTx recipients up to one year posttransplant. Although only one iITx patient experienced GVHD, T cell mixed chimerism was detected in 8 out of 9 iITx/MVTx recipients. Chimerism was significantly lower in the four subjects who displayed early moderate to severe rejection. Pre-formed high-titer donor-specific antibodies, bound in vivo to the circulating donor cells, were associated with an accelerated decline in chimerism. Blood chimerism was also studied in 10 iLTx controls. Among nonsensitized patients, MVTx recipients exhibited greater T and B cell chimerism than either iITx or iLTx recipients. Myeloid lineage chimerism was present exclusively among iLTx and MVTx (6/13) recipients, suggesting that its presence required the hepatic allograft. Our study demonstrates, for the first time, frequent T cell chimerism without GVHD following visceral transplantation and a possible relationship with reduced rejection rate in MVTx recipients.
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: J
authors.initials: J
authors.lastname: Zuber
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Rosen
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: B
authors.initials: B
authors.lastname: Shonts
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: B
authors.initials: B
authors.lastname: Sprangers
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: T M
authors.initials: TM
authors.lastname: Savage
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Richman
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Yang
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: S P
authors.initials: SP
authors.lastname: Lau
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: DeWolf
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: D
authors.initials: D
authors.lastname: Farber
authors.affiliation: Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY.
authors.forename: G
authors.initials: G
authors.lastname: Vlad
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: E
authors.initials: E
authors.lastname: Zorn
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
authors.forename: W
authors.initials: W
authors.lastname: Wong
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, NY.
authors.forename: J
authors.initials: J
authors.lastname: Emond
authors.affiliation: Department of Biostatistics, Columbia University Medical Center, New York, NY.
authors.forename: B
authors.initials: B
authors.lastname: Levin
authors.affiliation: Departments of Pediatrics, Columbia University Medical Center, New York, NY.
authors.forename: M
authors.initials: M
authors.lastname: Martinez
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, NY.
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.affiliation: Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.|Department of Surgery, Columbia University Medical Center, New York, NY.|Department of Microbiology & Immunology, Columbia University Medical Center, New York, NY.|Department of Medicine, Columbia University Medical Center, New York, NY.
authors.forename: M
authors.initials: M
authors.lastname: Sykes
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000276:immunology*; D006086:Graft vs Host Disease / Q000097:blood / Q000276:immunology*; D006801:Humans; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D018183:Transplantation Chimera / Q000097:blood / Q000276:immunology*; D055815:Young Adult
keywords: flow cytometry; lymphocyte biology; monitoring immune; trafficking