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Safety and efficacy of autologous mesenchymal stromal cells transplantation in patients undergoing living donor kidney transplantation: A pilot study
Author(s) -
Mudrabettu Chetan,
Kumar Vinod,
Rakha Aruna,
Yadav Ashok K,
Ramachandran Raja,
Kanwar Deepesh B,
Nada Ritambhra,
Minz Mukut,
Sakhuja Vinay,
Marwaha Neelam,
Jha Vivekanand
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12338
Subject(s) - medicine , mesenchymal stem cell , immunosuppression , foxp3 , transplantation , calcineurin , il 2 receptor , adverse effect , kidney transplantation , stromal cell , immunophenotyping , cell therapy , surgery , t cell , urology , oncology , stem cell , pathology , immunology , immune system , flow cytometry , biology , genetics
Aim This pilot study assesses the safety and feasibility of autologous mesenchymal stromal cell ( MSC ) transplantation in four patients that underwent living donor renal transplantation, and the effect on the immunophenotype and functionality of peripheral T lymphocytes following transplantation. Methods All patients received low dose ATG induction followed by calcineurin inhibitor‐based triple drug maintenance immunosuppression. Autologous MSCs were administered intravenously pre transplant and day 30 post‐transplant. Patients were followed up for 6 months. The frequency of regulatory T cells and T cell proliferation was assessed at different time points. Results None of the four patients developed any immediate or delayed adverse effects following MSC infusion. All had excellent graft function, and none developed graft dysfunction. Protocol biopsies at 1 and 3 months did not reveal any abnormality. Compared to baseline, there was an increase in the CD4 + CD25 + FOXP3 + regulatory T cells and reduction in CD4 T cell proliferation. Conclusion We conclude that autologous MSCs can be used safely in patients undergoing living donor renal transplantation, lead to expansion of regulatory T cells and decrease in T cell proliferation. Larger randomized trials studies are needed to confirm these findings and evaluate whether this will have any impact on immunosuppressive therapy.