Preoperative treatment of a presensitized kidney transplant recipient with donor-derived transplant acceptance-inducing cells

Transpl Int. 2008 Aug;21(8):808-13. doi: 10.1111/j.1432-2277.2008.00712.x. Epub 2008 Jul 10.

Abstract

This report describes the case of patient FR, a 31-year-old recipient of a living-related kidney transplant from a donor against whom he was presensitized. Seventeen days prior to transplantation, a central venous infusion of transplant acceptance-inducing cells (TAICs) was administered to the patient. During the 27-month follow up, the patient experienced no acute rejection episodes under an immunosuppressive regime comprising anti-thymocyte globulin (ATG) induction, corticosteroids and tacrolimus. In a similar manner to the kidney transplant recipients treated preoperatively with TAICs in a previous study, patient FR achieved a state of donor-specific hypo-responsiveness. Most remarkably, the deliberate preoperative exposure of a sensitized patient to the sensitizing alloantigen did not heighten his response; on the contrary, after TAIC treatment and transplantation, HLA-specific antibodies were no longer detectable. The case of patient FR provides further evidence of the safety of pre-transplantation treatment with TAICs.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cell- and Tissue-Based Therapy
  • HLA Antigens / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infusions, Intravenous
  • Isoantibodies / analysis
  • Kidney Transplantation*
  • Lymphocyte Culture Test, Mixed
  • Macrophages / immunology*
  • Male
  • Tissue Donors
  • Transplantation Conditioning*
  • Transplantation Tolerance / immunology*

Substances

  • HLA Antigens
  • Immunosuppressive Agents
  • Isoantibodies