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Related Concept Videos

Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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Orthotopic Hind Limb Transplantation in the Mouse
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[Transplant tolerance through mixed chimerism].

Julien Zuber1

  • 1Service de transplantation rénale, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France.

Nephrologie & Therapeutique
|June 5, 2017
PubMed
Summary
This summary is machine-generated.

Pilot studies show mixed chimerism can induce transplant tolerance. While sustained chimerism allows immunosuppression withdrawal, it risks graft-versus-host disease; transient chimerism offers a safer alternative.

Keywords:
Chimérisme mixteCombined kidney and bone marrow transplantationMixed chimerismToleranceToléranceTransplantation combinée

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Area of Science:

  • Immunology
  • Transplantation Biology
  • Cellular Therapy

Background:

  • Operational tolerance is crucial for long-term transplant success.
  • Mixed chimerism has shown promise in inducing operational tolerance.
  • Previous studies explored combined kidney and hematopoietic cell transplantation.

Purpose of the Study:

  • To evaluate the feasibility of inducing operational tolerance via mixed chimerism.
  • To assess the safety and efficacy of different chimerism induction strategies.
  • To elucidate the mechanisms underlying transplant tolerance in mixed chimerism models.

Main Methods:

  • Three pilot studies involving combined kidney and hematopoietic cell transplantation.
  • Induction of sustained or transient mixed chimerism.
  • Assessment of immunosuppression withdrawal and graft rejection.
  • Monitoring for graft-versus-host disease and immune tolerance markers.

Main Results:

  • Sustained mixed chimerism enabled safe immunosuppression withdrawal in two studies.
  • Achieving sustained chimerism required harsh cytoreductive regimens and risked graft-versus-host disease.
  • Transient mixed chimerism was induced with less cytotoxic regimens, leading to tolerance.
  • Mechanisms of tolerance in transient chimerism involve T cell exhaustion, deletion, and suppression.

Conclusions:

  • Mixed chimerism is a viable strategy for inducing operational transplant tolerance.
  • Transient mixed chimerism offers a safer approach with complex immune mechanisms.
  • Further research is needed to optimize chimerism induction and mitigate risks.