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

P. Fontes, A. S. Rao, P. Carroll, F. Dodson, R. Shapiro, A. Tzakis, S. Todo, K. Abu-Elmagd, M. Jordon, J. J. Fung, T. E. Starzl, A. J. Demetris, A. Zeevi, M. Trucco, W. A. Rudert, W. Rybka, C. Ricordi

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Abstract

Summary. 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 108 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-antigen HLA matched same sex donor precluded detection of chimerism in one patient.

Original languageEnglish (US)
Pages (from-to)151-155
Number of pages5
JournalThe Lancet
Volume344
Issue number8916
DOIs
StatePublished - Jul 16 1994

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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    Fontes, P., Rao, A. S., Carroll, P., Dodson, F., Shapiro, R., Tzakis, A., Todo, S., Abu-Elmagd, K., Jordon, M., Fung, J. J., Starzl, T. E., Demetris, A. J., Zeevi, A., Trucco, M., Rudert, W. A., Rybka, W., & Ricordi, C. (1994). Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation. The Lancet, 344(8916), 151-155. https://doi.org/10.1016/S0140-6736(94)92756-1