Bone marrow transfusions in cadaver renal allografts: pilot trials with concurrent controls

Light, Jimmy A.; Salomon, Daniel R.; Diethelm, Arnold G.; Alexander, J. Wesley; Hunsicker, Lawrence G.; Thistlethwaite, Richard; Reinsmoen, Nancy L.; Stablein, Donald M.

doi:10.1034/j.1399-0012.2002.02056.x

Cited by 20 publications

(8 citation statements)

References 28 publications

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“…However, these cases are considered the first report of COT after metachronous bone marrow and RT. Subsequently, more cases of combined BMT and RT 56–61 —or solid organ transplants in general 62 —have been described. It is noteworthy to highlight that in all cases, the use of BMT with its potentially fatal complications such as graft-versus-host disease was justified on the basis of the need for treatment of hematological malignancies.…”

Section: Group C: Implementation Of Protocols In Which Clinical Operamentioning

confidence: 99%

Clinical Operational Tolerance After Renal Transplantation

et al. 2010

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In solid organ transplantation, the achievement of an immunosuppression (IS)-free state [also referred to as clinical operational tolerance (COT)] represents the ultimate goal. Although COT is feasible and safe in selected cases after liver transplantation, it is an exceptional finding after other types of solid organ transplantation. In the field of renal transplantation (RT), approximately 100 cases of COT have been reported to date, mainly in patients who were not compliant with their immunosuppressive regimens or in individuals who had previously received a bone marrow transplant for hematological disorders. On the basis of promising results obtained in animal models, several tolerogenic protocols have been attempted in humans, but most have failed to achieve robust and stable COT after RT. Molecule-based regimens have been largely ineffective, whereas cell-based regimens have provided some encouraging results. In these latter regimens, apart from standard IS, patients usually receive perioperative infusion of donor bone marrow–derived stem cells, which are able to interact with the immune cells of the host and mitigate their response to engraftment. Unfortunately, most renal transplant patients who developed acute rejection—occurring either during the weaning protocol or after complete withdrawal of IS—eventually lost their grafts. Currently, the immune monitoring necessary for predicting the presence and persistence of donor-specific unresponsiveness is not available. Overall, the present review will provide a conceptual framework for COT and conclude that stable and robust COT after RT remains an elusive goal and that the different strategies attempted to date are not yet reproducibly safe or effective.

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Section: Group C: Implementation Of Protocols In Which Clinical Operamentioning

confidence: 99%

Clinical Operational Tolerance After Renal Transplantation

et al. 2010

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“…Thus, many groups have tried to coinfuse small doses of donor bone marrow together with the transplanted organ (4,16,57). This approach seems to be associated with a lower rejection incidence without appearance of GVHD and allows long-term microchimerism detection.…”

Section: Discussionmentioning

confidence: 99%

Early Hematopoietic Microchimerism Predicts Clinical Outcome After Kidney Transplantation

et al. 2007

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“…15 Interestingly, none of the following studies were able to induce donor-specific tolerance (ie, "Holy Grail"), but there was an associated decreased incidence of acute and chronic rejection. 16 Fortunately, there have been no reported cases of GVHD in any CTA patients. GVHD develops when the donor lymphocytes recognize the recipient's antigens as foreign.…”

Section: Chronic Rejectionmentioning

confidence: 99%

Requirements for the Development of a Hand Transplantation Program

Gordon

Siemionow

2009

Annals of Plastic Surgery

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Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.

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Bone marrow transfusions in cadaver renal allografts: pilot trials with concurrent controls

Cited by 20 publications

References 28 publications

Clinical Operational Tolerance After Renal Transplantation

Clinical Operational Tolerance After Renal Transplantation

Early Hematopoietic Microchimerism Predicts Clinical Outcome After Kidney Transplantation

Requirements for the Development of a Hand Transplantation Program

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