Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation

Lancet. 1994 Jul 16;344(8916):151-5. doi: 10.1016/s0140-6736(94)92756-1.

Abstract

We have previously postulated that donor cell chimerism in organ transplantation is needed to attain a tolerant state. Here we show that donor cell chimerism can be augmented in organ recipients if they are infused perioperatively with 3 x 10(8) per kg of unmodified donor bone marrow cells and are kept on a conventional immunosuppressive regimen of tacrolimus (FK506) and prednisolone. 36 patients took part, of whom the first 18 patients have good transplanted kidney (n = 10), liver (n = 7), and heart (n = 7) function when followed up between 4 and 16 months. All patients are well. We found persistent multilineage leucocyte chimerism in blood of 17 recipients by flow cytometry and PCR techniques to detect donor alleles or Y chromosomes in female recipients of male organs. The use of the 5-antigben HLA matched same sex donor precluded detection of chimerism in one patient.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bone Marrow Transplantation / immunology*
  • Female
  • Follow-Up Studies
  • Graft Rejection / immunology
  • Graft Survival / immunology*
  • Humans
  • Islets of Langerhans Transplantation / immunology*
  • Male
  • Middle Aged
  • Organ Transplantation*
  • Transplantation Chimera / immunology*
  • Transplantation Immunology*