Department of Surgery, Karl Olga Hospital Stuttgart, Stuttgart, Germany.
Am J Transplant. 2011 Jan;11(1):156-62. doi: 10.1111/j.1600-6143.2010.03352.x.
In January 2005, an 18-year-old male patient with acute myeloid leukemia (AML) received a haploidentical hematopoietic stem cell transplantation (HSCT) from his father. He developed hemolytic uremic syndrome and end-stage renal disease (ESRD) requiring hemodialysis on day 357 after HSCT. On day 1020 after HSCT, a living kidney donation from the stem cell donor was carried out. The creatinine before kidney transplantation (KT) was ≈450 μmol/L, 268 μmol/L on day 2 after KT, 88 μM on day 38 and 89 μmol/L on day 960 (day 1980 after HSCT). Immunosuppression was gradually discontinued: cortisone on day 28, tacrolimus on day 32 and MMF on day 100 after KT (day 1120 after HSCT). As of June 2010, 66 months after HSCT and 32 months after KT, the patient has had neither rejection episodes nor clinical manifestations of transplantation-related complications. The patient reached 100% hematopoietic donor chimerism prekidney transplant and retained this state postkidney transplant. This unique case is the first report of a successful kidney transplant without immunosuppression after HSCT from the same haploidentical donor.
2005 年 1 月，一名 18 岁男性急性髓系白血病（AML）患者接受了来自其父亲的单倍体造血干细胞移植（HSCT）。他在 HSCT 后 357 天出现溶血性尿毒症综合征和终末期肾病（ESRD），需要血液透析。在 HSCT 后 1020 天，进行了来自干细胞供体的活体肾脏捐赠。移植前（KT）的肌酐约为 450μmol/L，KT 后第 2 天为 268μmol/L，第 38 天为 88μM，第 960 天（HSCT 后第 1980 天）为 89μmol/L。免疫抑制剂逐渐停用：KT 后第 28 天停用可的松，第 32 天停用他克莫司，第 100 天停用 MMF（HSCT 后第 1120 天）。截至 2010 年 6 月，HSCT 后 66 个月和 KT 后 32 个月，患者既没有排斥反应，也没有移植相关并发症的临床表现。患者在移植前达到 100%造血供体嵌合体，移植后仍保持这种状态。这是首例从同一单倍体供体成功进行 HSCT 后无免疫抑制的肾脏移植的报道。
