Living donor liver transplantation and tolerance

A potential strategy in cholangiocarcinoma

Zakiyah Kadry, Beat Mullhaupt, Eberhard L. Renner, Peter Bauerfeind, Urs Schanz, Bernhard C. Pestalozzi, Gabriella Studer, Rolf Zinkernagel, Pierre Alain Clavien

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background. Donor-specific immune tolerance has been reported in isolated cases of kidney transplantation associated with bone marrow transplantation. The following is a description of a living donor liver transplantation for a hilar cholangiocarcinoma in a previous recipient of an allogeneic bone marrow transplant. Method. A right hemi-liver transplantation was performed using a liver allograft obtained from the same previous bone marrow donor. A neoadjuvant chemoirradiation protocol was implemented before the procedure. Because of the presence of full chimerism, no immunosuppression has been necessary for the last 22 months. Results. Liver graft function has remained excellent, and a magnetic resonance imaging scan at one and a half years has shown no tumor recurrence. A control liver biopsy at 1 year showed no rejection. Conclusions. Neoadjuvant chemo-irradiation therapy and removal of all immunosuppression after liver transplantation formed the basic structure of this approach. Additional benefits provided by living donor liver transplantation included limitation of tumor progression by diminishing the pretransplantation waiting time, radical excision of the tumor through a complete hepatectomy, and optimal timing of the transplant procedure within a neoadjuvant chemo-irradiation protocol.

Original languageEnglish (US)
Pages (from-to)1003-1006
Number of pages4
JournalTransplantation
Volume76
Issue number6
DOIs
StatePublished - Sep 27 2003

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Transplantation Tolerance
Cholangiocarcinoma
Living Donors
Liver Transplantation
Transplants
Immunosuppression
Liver
Klatskin Tumor
Bone Marrow
Tissue Donors
Neoplasms
Immune Tolerance
Chimerism
Hepatectomy
Bone Marrow Transplantation
Kidney Transplantation
Allografts
Magnetic Resonance Imaging
Biopsy
Recurrence

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Kadry, Z., Mullhaupt, B., Renner, E. L., Bauerfeind, P., Schanz, U., Pestalozzi, B. C., ... Clavien, P. A. (2003). Living donor liver transplantation and tolerance: A potential strategy in cholangiocarcinoma. Transplantation, 76(6), 1003-1006. https://doi.org/10.1097/01.TP.0000083981.82522.13
Kadry, Zakiyah ; Mullhaupt, Beat ; Renner, Eberhard L. ; Bauerfeind, Peter ; Schanz, Urs ; Pestalozzi, Bernhard C. ; Studer, Gabriella ; Zinkernagel, Rolf ; Clavien, Pierre Alain. / Living donor liver transplantation and tolerance : A potential strategy in cholangiocarcinoma. In: Transplantation. 2003 ; Vol. 76, No. 6. pp. 1003-1006.
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abstract = "Background. Donor-specific immune tolerance has been reported in isolated cases of kidney transplantation associated with bone marrow transplantation. The following is a description of a living donor liver transplantation for a hilar cholangiocarcinoma in a previous recipient of an allogeneic bone marrow transplant. Method. A right hemi-liver transplantation was performed using a liver allograft obtained from the same previous bone marrow donor. A neoadjuvant chemoirradiation protocol was implemented before the procedure. Because of the presence of full chimerism, no immunosuppression has been necessary for the last 22 months. Results. Liver graft function has remained excellent, and a magnetic resonance imaging scan at one and a half years has shown no tumor recurrence. A control liver biopsy at 1 year showed no rejection. Conclusions. Neoadjuvant chemo-irradiation therapy and removal of all immunosuppression after liver transplantation formed the basic structure of this approach. Additional benefits provided by living donor liver transplantation included limitation of tumor progression by diminishing the pretransplantation waiting time, radical excision of the tumor through a complete hepatectomy, and optimal timing of the transplant procedure within a neoadjuvant chemo-irradiation protocol.",
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Kadry, Z, Mullhaupt, B, Renner, EL, Bauerfeind, P, Schanz, U, Pestalozzi, BC, Studer, G, Zinkernagel, R & Clavien, PA 2003, 'Living donor liver transplantation and tolerance: A potential strategy in cholangiocarcinoma', Transplantation, vol. 76, no. 6, pp. 1003-1006. https://doi.org/10.1097/01.TP.0000083981.82522.13

Living donor liver transplantation and tolerance : A potential strategy in cholangiocarcinoma. / Kadry, Zakiyah; Mullhaupt, Beat; Renner, Eberhard L.; Bauerfeind, Peter; Schanz, Urs; Pestalozzi, Bernhard C.; Studer, Gabriella; Zinkernagel, Rolf; Clavien, Pierre Alain.

In: Transplantation, Vol. 76, No. 6, 27.09.2003, p. 1003-1006.

Research output: Contribution to journalArticle

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T1 - Living donor liver transplantation and tolerance

T2 - A potential strategy in cholangiocarcinoma

AU - Kadry, Zakiyah

AU - Mullhaupt, Beat

AU - Renner, Eberhard L.

AU - Bauerfeind, Peter

AU - Schanz, Urs

AU - Pestalozzi, Bernhard C.

AU - Studer, Gabriella

AU - Zinkernagel, Rolf

AU - Clavien, Pierre Alain

PY - 2003/9/27

Y1 - 2003/9/27

N2 - Background. Donor-specific immune tolerance has been reported in isolated cases of kidney transplantation associated with bone marrow transplantation. The following is a description of a living donor liver transplantation for a hilar cholangiocarcinoma in a previous recipient of an allogeneic bone marrow transplant. Method. A right hemi-liver transplantation was performed using a liver allograft obtained from the same previous bone marrow donor. A neoadjuvant chemoirradiation protocol was implemented before the procedure. Because of the presence of full chimerism, no immunosuppression has been necessary for the last 22 months. Results. Liver graft function has remained excellent, and a magnetic resonance imaging scan at one and a half years has shown no tumor recurrence. A control liver biopsy at 1 year showed no rejection. Conclusions. Neoadjuvant chemo-irradiation therapy and removal of all immunosuppression after liver transplantation formed the basic structure of this approach. Additional benefits provided by living donor liver transplantation included limitation of tumor progression by diminishing the pretransplantation waiting time, radical excision of the tumor through a complete hepatectomy, and optimal timing of the transplant procedure within a neoadjuvant chemo-irradiation protocol.

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