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

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

P Fontes  1 , A S Rao, A J Demetris, A Zeevi, M Trucco, P Carroll, W Rybka, W A Rudert, C Ricordi, F Dodson, et al.
Affiliations

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

P Fontes et al. Lancet. .

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.

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Figures

Figure 1
Figure 1
Immunosuppression and MLR responses to irradiated donor and third-party cells, and donor cell chimerism by flow cytometry for case 18 in the first 6 months after heart-bone marrow transplantation.
Figure 2
Figure 2
In situ hybridisation for Y chromosome (arrows) in leucocytes obtained from a female recipient of a male organ (case 11), 120 days after kidney-bone marrow transplantation (× 1000)
Figure 3
Figure 3. MLR of a kidney-bone marrow recipient (case 14)
Mean (SD) of [3H]thymidine incorporation
See this image and copyright information in PMC

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