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Related Experiment Videos

Microchimerism and rejection in clinical transplantation

E T Elwood1, C P Larsen, D H Maurer

  • 1Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

Lancet (London, England)
|May 10, 1997
PubMed
Summary

Donor cell persistence after organ transplant varies over time. Detecting microchimerism with a single post-transplant blood test may not guide individual patient care effectively.

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Area of Science:

  • Immunology
  • Transplantation Science
  • Molecular Biology

Background:

  • Haemopoietic microchimerism is observed in solid-organ transplant recipients.
  • It is hypothesized to be crucial for developing and maintaining immunological tolerance.
  • This study investigates the link between donor cell persistence and clinical outcomes.

Purpose of the Study:

  • To prospectively correlate donor cell persistence with clinical outcomes in kidney, kidney-pancreas, and liver transplant recipients.
  • To assess the significance of microchimerism in post-transplant immunological responses.

Main Methods:

  • Donor cells in recipient peripheral blood were tracked using a nested PCR technique targeting donor MHC HLA DR genes.
  • Samples were collected at 3 days, and 1, 3, 6, and 12 months post-transplantation.

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  • Pre-transplant samples were used as negative controls; 25 liver, 13 kidney-pancreas, and 17 kidney recipients were analyzed.

    • Main Results:

    • Donor DNA was detected in 80% of recipients at 3 days, decreasing to 32% at 12 months.
    • Detection of donor DNA varied significantly over time within individuals.
    • No significant difference in rejection episodes was observed between patients with and without detectable microchimerism.

    Conclusions:

    • A substantial proportion of transplant recipients exhibit persistent donor class II DNA for up to a year.
    • Pre-transplant blood samples are essential to prevent false-positive results.
    • The temporal variability of microchimerism suggests single post-transplant analyses may be insufficient for clinical decision-making.