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Blood Chimerism in Dizygotic Monochorionic Twins During 5 Years Observation
Author(s) -
Dziegiel M. H.,
Hansen M. H.,
Haedersdal S.,
Barrett A. N.,
Rieneck K.,
Main K. M.,
Hansen A. T.,
Clausen F. B.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14318
Subject(s) - medicine , stem cell , transplantation , andrology , immunology , monochorionic twins , fetus , pregnancy , genetics , biology
Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin‐to‐twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells by flow cytometry and the proportion of allogeneic nucleated cells by digital polymerase chain reaction at 7 months and again at 5 years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modeled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells. The procedure would hold the promise of transplantation and tolerance induction without myeloablative conditioning for inheritable benign hematological diseases such as sickle cell disease and thalassemia.