A novel bone marrow transplantation strategy for donor-specific tolerance induction after heart transplantation
10.3760/cma.j.issn.0254-1785.2011.01.009
- VernacularTitle:骨髓移植诱导临床心脏移植后供者特异性免疫耐受方案的探讨
- Author:
Kequan GUO
;
Xu MENG
;
Yuanlong YU
;
Jie HAN
;
Haiming JIANG
;
Xiaojun XU
;
Xiaojun LU
;
Yixin JIA
;
Junmeng ZHENG
;
Haibo ZHANG
;
Yan LI
;
Tie ZHENG
;
Chunlei XU
;
Wen ZENG
;
Jiangang WANG
;
Yongqiang CUI
;
Tiange LUO
;
Jun WANG
;
Susumu IKEHARA
- Publication Type:Journal Article
- Keywords:
Heart transplantation;
Bone marrow transplantation;
Perfusion method;
Immune tolerance;
Chimera
- From:
Chinese Journal of Organ Transplantation
2011;32(1):32-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate a new strategy of bone marrow transplantation (BMT) for donor-specific tolerance induction after heart transplantation. Methods Donor bone marrow cells (BMCs)were harvested simultaneously with donor cardiac graft using modified perfusion method (PM) ,then stored in a -80 ℃ refrigerator after filtration and centrifugation. Whole BMCs (IBM-BMT) (monocytes 1.2 ×107/kg,CD34+ cells 2.38× 105/kg) in host iliac bones were injected into the bone marrow cavity 40 days after heart transplantation. Preconditoning regimens that consisted of fludarabine, antithymoctye globin and total lymphoid irradiation were performed 3 days before BMT. Tacrolimus (Tac) was administrated intravenously after BMT or orally in conjunction with mycophenolate mofetil (MMF) 3 weeks later.Cyclosporine and MMF were orally administrated 6 weeks later. Donor chimerism was detected using short tandem repeats-polymerase chain reaction in monocytes from peripheral blood at the 2nd,4th, 8th or 12th week after BMT or BMCs at the 4th, 8th or 12th week after BMT. Intramyocardium electrocardiography examination or endomyocardial biopsy was performed weekly or monthly respectively. Mixed lymphocyte reactions (MLR) were performed 3 months after BMT. Results Donor chimerism in monocytes in peripheral blood or BMCs in iliac bones measured at the 1 st,2nd and 3rd month after BMT was 26.3%, 19.1%,4.8% ,and 46.3%, 24.4%, 7.6%, respectively. After 3-month follow-up, there was no rejection confirmed by endomyocardial biopsy or intramyocardium electrocardiography. Echocardiography revealed that the diastolic and systolic function of the cardiac graft was maintained well 3 months after BMT. MLR revealed donor-specific hyporesponsiveness while immunocompetence was preserved to third-party antigens. Conclusion These findings indicate that the two-stage BMT strategy is a safe and feasible method for the induction of donor-specific tolerance via stable mixed chimerism and needs to be further confirmed after a long-term observation.
