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

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, 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 language	English (US)
Pages (from-to)	151-155
Number of pages	5
Journal	The Lancet
Volume	344
Issue number	8916
DOIs	https://doi.org/10.1016/S0140-6736(94)92756-1
State	Published - Jul 16 1994

All Science Journal Classification (ASJC) codes

General Medicine

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10.1016/S0140-6736(94)92756-1

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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

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

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.",

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

note = "Funding Information: Aided by Project Grant No DK 29961 from the National Insitutes of Health, Bethesda, Maryland.",

year = "1994",

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doi = "10.1016/S0140-6736(94)92756-1",

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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

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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.

N1 - Funding Information: Aided by Project Grant No DK 29961 from the National Insitutes of Health, Bethesda, Maryland.

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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ER -

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

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