Immune status of recipients following bone marrow - Augmented solid organ transplantation

Adriana Zeevi, Mary Pavlick, Susan Lombardozzi, Richard Banas, Orit Pappo, Abdul S. Rao, Paulo Fontes, Jake Demetris, Ron Shapiro, Forrest Dodson, Massimo Trucco, Pat Carroll, Si Pham, John J. Fung, Thomas E. Starzl

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

It has been postulated that the resident “passenger” leukocytes of hematolymphoid origin that migrate from whole organ grafts and subsequently establish systemic chimerism are essential for graft acceptance and the induction of donor-specific nonreactivity. This phenomenon was augmented by infusing 3 × 108 unmodified donor bone-marrow cells into 40 patients at the time of organ transplantation. Fifteen of the first 18 analyzable patients had sequential immunological evaluation over postoperative intervals of 5 to 17 months, (which included 7 kidney (two with islets), 7 liver (one with islets), and one heart recipient). The evolution of changes was compared with that in 16 kidney and liver nonmarrow controls followed for 4 to5 months. The generic immune reactivity of peripheral blood mononuclear cells (PBMC) was determined by their proliferative responses to mitogens (PHA, ConA). Alloreactivity was measured by the recipient mixed lymphocyte reaction (MLR) to donor and HLA-mis-matched third-party panel cells. Based on all 3 tests,the recipients were classified as donor-specific hyporeactive, intermediate, and responsive; patients who were globally suppressed made up a fourth category. Eight (53%) of the 15 marrow-treated recipients exhibited progressive modulation of donor-specific reactivity (3 hyporeactive and 5 intermediate) while 7 remained antidonor-responsive. In the nonmarrow controls, 2 (12.5%) of the 16 patients showed donor-specific hyporeactivity, 10 (62.5%) were reactive, and 4 (25%) studied during a CMV infection had global suppression of responsiveness to all stimuli.

Original languageEnglish
Pages (from-to)616-620
Number of pages5
JournalTransplantation
Volume59
Issue number4
DOIs
StatePublished - 27 Feb 1995
Externally publishedYes

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