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Combined simultaneous kidney/bone marrow transplantation

R Shapiro1, A S Rao, P Fontes

  • 1Department of Surgery, Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.

Transplantation
|December 27, 1995
PubMed
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Combined kidney and bone marrow transplantation shows promising results, with high graft survival and increased chimerism. This approach offers a viable option for patients needing kidney transplants without increasing early complications.

Area of Science:

  • Transplantation immunology
  • Nephrology
  • Hematology

Background:

  • Long-term renal allograft survival is linked to systemic microchimerism.
  • This observation prompted the development of combined transplantation protocols.

Purpose of the Study:

  • To evaluate the efficacy and safety of simultaneous kidney and bone marrow transplantation.
  • To assess patient and allograft survival rates.
  • To investigate the incidence of chimerism and immunological responses.

Main Methods:

  • 36 kidney transplant recipients received unmodified bone marrow cells alongside kidney transplants.
  • Control group received kidney transplants alone.
  • Tacrolimus-based immunosuppression was used for all patients.

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  • Chimerism and immunological parameters were monitored post-transplantation.

    • Main Results:

    • All 36 study patients survived with a 92% functioning allograft rate at mean follow-up.
    • Chimerism was detected in 97% of study patients, significantly higher than controls (64%).
    • Graft-versus-host disease was not observed; rejection and CMV incidence were comparable to controls.

    Conclusions:

    • Combined kidney/bone marrow transplantation is associated with acceptable patient and graft survival.
    • The procedure effectively augments chimerism.
    • Early post-transplant events and complications were not adversely affected.