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

Research output: Contribution to journalArticle

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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

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Pancreas Transplantation
Islets of Langerhans Transplantation
Chimerism
Bone Marrow
Tissue Donors
Kidney
Liver
Tacrolimus
Y Chromosome
Organ Transplantation
Immunosuppressive Agents
HLA Antigens
Prednisolone
Bone Marrow Cells
Flow Cytometry
Leukocytes
Alleles
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Fontes, P., Rao, A. S., Carroll, P., Dodson, F., Shapiro, R., Tzakis, A., ... 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
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. / Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation. In: The Lancet. 1994 ; Vol. 344, No. 8916. pp. 151-155.
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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.",
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Fontes, P, Rao, AS, Carroll, P, Dodson, F, Shapiro, R, Tzakis, A, Todo, S, Abu-Elmagd, K, Jordon, M, Fung, JJ, Starzl, TE, Demetris, AJ, Zeevi, A, Trucco, M, Rudert, WA, Rybka, W & Ricordi, C 1994, 'Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation', The Lancet, vol. 344, no. 8916, pp. 151-155. https://doi.org/10.1016/S0140-6736(94)92756-1

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

In: The Lancet, Vol. 344, No. 8916, 16.07.1994, p. 151-155.

Research output: Contribution to journalArticle

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T1 - Bone marrow augmentation of donor-cell chimerism in kidney, liver, heart, and pancreas islet transplantation

AU - Fontes, P.

AU - Rao, A. S.

AU - Carroll, P.

AU - Dodson, F.

AU - Shapiro, R.

AU - Tzakis, A.

AU - Todo, S.

AU - Abu-Elmagd, K.

AU - Jordon, M.

AU - Fung, J. J.

AU - Starzl, T. E.

AU - Demetris, A. J.

AU - Zeevi, A.

AU - Trucco, M.

AU - Rudert, W. A.

AU - Rybka, W.

AU - Ricordi, C.

PY - 1994/7/16

Y1 - 1994/7/16

N2 - 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.

AB - 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.

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