Mixed Chimerism and Acceptance of Kidney Transplants after Immunosuppressive Drug Withdrawal

Scheduled for Tuesday, March 30, 2020, from 2:00 PM ET to 3:00 PM ET • Hosted by the Community of Transplant Scientists (COTS)

"Mixed Chimerism and Acceptance of Kidney Transplants after Immunosuppressive Drug Withdrawal"
(Science Translational Medicine 29 Jan 2020:Vol. 12, Issue 528, eaax8863; DOI: 10.1126/scitranslmed.aax8863)

In this article:
Preclinical studies have shown that persistent mixed chimerism is linked to acceptance of organ allografts without immunosuppressive (IS) drugs... To determine whether persistent mixed chimerism and tolerance can be established in patients undergoing living donor kidney transplantation, [the authors] infused allograft recipients with donor T cells and hematopoietic progenitors after posttransplant lymphoid irradiation. In 24 of 29 fully human leukocyte antigen (HLA)–matched patients who had persistent mixed chimerism for at least 6 months, complete IS drug withdrawal was achieved without subsequent evidence of rejection for at least 2 years. In 10 of 22 HLA haplotype–matched patients with persistent mixed chimerism for at least 12 months, reduction of IS drugs to tacrolimus monotherapy was achieved... In conclusion, persistent mixed chimerism established in fully HLA- or haplotype-matched patients allowed for complete or partial IS drug withdrawal without rejection.

- Stephan Busque, MD; Stanford University School of Medicine, Stanford, CA
- Samuel Strober, MD; Stanford University School of Medicine, Stanford, CA

- Aman Bajwa, PhD; University of Tennessee Health Science Center, Memphis, TN

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