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Preoperative treatment of a presensitized kidney transplant recipient with donor-derived transplant acceptance-inducing cells

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Abstract:

Summary

This report describes the case of patient FR, a 31-year-old recipient of a living-related kidney transplant from a donor against whom he was presensitized. Seventeen days prior to transplantation, a central venous infusion of transplant acceptance-inducing cells (TAICs) was administered to the patient. During the 27-month follow up, the patient experienced no acute rejection episodes under an immunosuppressive regime comprising anti-thymocyte globulin (ATG) induction, corticosteroids and tacrolimus. In a similar manner to the kidney transplant recipients treated preoperatively with TAICs in a previous study, patient FR achieved a state of donor-specific hypo-responsiveness. Most remarkably, the deliberate preoperative exposure of a sensitized patient to the sensitizing alloantigen did not heighten his response; on the contrary, after TAIC treatment and transplantation, HLA-specific antibodies were no longer detectable. The case of patient FR provides further evidence of the safety of pre-transplantation treatment with TAICs.

Keywords: TAIC; cell-based immunotherapy; tolerance; transplantation

Document Type: Case Report

DOI: http://dx.doi.org/10.1111/j.1432-2277.2008.00712.x

Affiliations: 1:  Laboratory of Transplantation Research of the Clinic of General and Thoracic Surgery, University of Schleswig-Holstein, Kiel, Germany 2:  Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands 3:  Department of Nephrology, University Duisburg-Essen, Essen, Germany 4:  Department of Immunology, University of Schleswig-Holstein, Kiel, Germany 5:  Department of Nephrology, University of Schleswig-Holstein, Kiel, Germany 6:  Division of Experimental Surgery, Department of Surgery, University of Regensburg, Regensburg, Germany

Publication date: August 1, 2008

bsc/tri/2008/00000021/00000008/art00011
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