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Bone marrow transfusions in cadaver renal allografts: pilot trials with concurrent controls
Author(s) -
Light Jimmy,
Salomon Daniel R,
Diethelm Arnold G,
Alexander J Wesley,
Hunsicker Lawrence,
Thistlethwaite Richard,
Reinsmoen Nancy,
Stablein Donald M
Publication year - 2002
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2002.02056.x
Subject(s) - medicine , cadaver , bone marrow , bone marrow transplantation , surgery , bone marrow transplant , transplantation , pathology
Background: The safety and immune tolerance potential of donor marrow infusion with cadaveric source renal transplants was evaluated in a series of non‐randomized multicenter pilot trials by the NIH Cooperative Clinical Trials in Transplantation (CCTT) Group. Patients and methods: Three strategies were tested: (1) immunosuppression with cyclosporin, azathioprine and prednisone with a single post‐transplant day 1 infusion of 5 × 10 7 viable cells/kg, (2) OKT3 induction with triple drug therapy and marrow transfusion on day 1, or (3) same therapy as (2) but with an additional marrow transfusion on day 10–12. Results: Thirty‐eight marrow recipients and 35 contemporaneous controls were entered with a mean follow‐up of over 5 yr. Graft survival was initially better in the marrow recipients than the controls but was similar after 5 yr. Microchimerism rates were similar for the marrow infusion and control groups throughout the follow‐up period, regardless of the immunosuppression strategies. Discussion: Bone marrow infusions were well tolerated by a group of cadaver renal allograft recipients. There were no complications from the infusion(s), no episodes of graft‐vs.‐host disease (GVHD) and no increase in infections or other complications. There was a trend toward early improved graft survival in marrow recipients. Decreased rejection rates were observed in black recipients.