Open AccessMesenchymal stem cell transfusion for desensitization of positive lymphocyte cross‐match before kidney transplantation: outcome of 3 cases
Author(s) -
Saadi G.,
Fadel F.,
El Ansary M.,
ElHamid S. Abd
Publication year - 2013
Publication title -
cell proliferation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.647
H-Index - 74
eISSN - 1365-2184
pISSN - 0960-7722
DOI - 10.1111/cpr.12012
Subject(s) - plasmapheresis , medicine , desensitization (medicine) , transplantation , kidney transplantation , splenectomy , antibody , immunology , surgery , sensitization , spleen , receptor
Objectives Donor specific antibodies ( DSA ) and a positive cross‐match are contraindications for kidney transplantation. Trials of allograft transplantation across the HLA barrier have employed desensitization strategies, including the use of plasmapheresis, intravenous immunoglobulins, anti‐B‐cell monoclonal antibodies and splenectomy, associated with high‐intensity immunosuppressive regimens. Our case 1 report suffered from repeatedly positive lymphocyte cross match after 1st renal transplantation. Graft nephrectomy could not correct the state of sensitization. Splenectomy was done in a trial to get rid of the antibody producing clone. Furthermore plasmapheresis with low dose IVIG could not as well revert the state of sensitization for the patient. Material and methods About 50 millions donor specific MSC s were injected to the patient. Results MSC s transfusion proved to be the only procedure which could achieve successful desensitization before performing the second transplantation owing to their immunosuppressive properties. Conclusion This case indicates that DS ‐ MSC s is a potential option for anti‐ HLA desensitization. In cases 2 and 3 IV DS ‐ MSC s transfusion was selected from the start as a successful line of treatment for pre renal transplantation desensitization to save other unnecessary lines of treatment that were tried in case 1.