The New England journal of medicine · 2008
HLA-mismatched renal transplantation without maintenance immunosuppression.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Kawai Tatsuo, Cosimi A Benedict, Spitzer Thomas R, Tolkoff-Rubin Nina, Suthanthiran Manikkam, Saidman Susan L, Shaffer Juanita, Preffer Frederic I, Ding Ruchuang, Sharma Vijay, Fishman Jay A, Dey Bimalangshu, Ko Dicken S C, Hertl Martin, Goes Nelson B, Wong Waichi, Williams Winfred W, Colvin Robert B, Sykes Megan, Sachs David H
Аннотация
Five patients with end-stage renal disease received combined bone marrow and kidney transplants from HLA single-haplotype mismatched living related donors, with the use of a nonmyeloablative preparative regimen. Transient chimerism and reversible capillary leak syndrome developed in all recipients. Irreversible humoral rejection occurred in one patient. In the other four recipients, it was possible to discontinue all immunosuppressive therapy 9 to 14 months after the transplantation, and renal function has remained stable for 2.0 to 5.3 years since transplantation. The T cells from these four recipients, tested in vitro, showed donor-specific unresponsiveness and in specimens from allograft biopsies, obtained after withdrawal of immunosuppressive therapy, there were high levels of P3 (FOXP3) messenger RNA (mRNA) but not granzyme B mRNA.
Предметные рубрики MeSH
AdultBiopsyBone Marrow TransplantationCombined Modality TherapyFemaleGraft RejectionGranzymesHepatocyte Nuclear Factor 3-alphaHistocompatibility TestingHumansImmunosuppression TherapyKidneyKidney Failure, ChronicKidney TransplantationMaleMiddle AgedRNA, MessengerT-LymphocytesTransplantation ChimeraTransplantation ConditioningTransplantation ImmunologyTransplantation ToleranceTransplantation, Homologous