在活体供肾移植中，移植前共输注供者脂肪组织来源间充质干细胞和造血干细胞可能有助于获得免疫耐受。

Pre-transplant co-infusion of donor-adipose tissue derived mesenchymal stem cells and hematopoietic stem cells may help in achieving tolerance in living donor renal transplantation.

机构信息

Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, Gujarat , India .

出版信息

Ren Fail. 2014 Apr;36(3):457-60. doi: 10.3109/0886022X.2013.868295. Epub 2013 Dec 17.

DOI:10.3109/0886022X.2013.868295

PMID:24344734

Abstract

Transplantation tolerance is still a Utopian dream for many transplanters. Mesenchymal stem cells (MSC) have shown immuno-modulatory and tolerogenic effects in experimental models. We present a 29-year-old male with end stage renal disease (ESRD) who was transplanted with HLA 4/6 matched kidney from 51-year-old father in June 2010 preceded by co-infusion of donor-adipose tissue derived mesenchymal stem cells (AD-MSC) and bone marrow derived hematopoietic stem cells (BM-HSC) under non-myeloablative conditioning for deleting rejecting T and B-cells. He has maintained fairly stable graft function with serum creatinine (SCr) between 1.5 and 1.8 mg/dL at 3 years post-transplant with absence of donor specific antibodies (DSA), normal protocol graft biopsy, and peripheral T-regulatory cell levels (pTregs) (CD127(low/-)CD25(high)CD4+) of 4.57% on zero immunosuppression since 6 months.

摘要

移植耐受仍然是许多移植医生的一个乌托邦式的梦想。间充质干细胞（MSC）在实验模型中表现出免疫调节和耐受原性作用。我们介绍了一位 29 岁的男性，他患有终末期肾病（ESRD），于 2010 年 6 月接受了 HLA 4/6 匹配的肾脏移植，此前曾接受过供体脂肪组织来源的间充质干细胞（AD-MSC）和骨髓来源的造血干细胞（BM-HSC）共输注，以非清髓性条件预处理来清除排斥反应性 T 和 B 细胞。他在移植后 3 年的血清肌酐（SCr）保持在 1.5 至 1.8mg/dL 之间，功能相当稳定，没有供体特异性抗体（DSA），正常的方案移植活检，以及外周 T 调节细胞水平（pTregs）（CD127(low/-)CD25(high)CD4+）在零免疫抑制的情况下，自 6 个月以来为 4.57%。