Regenerative Medicine Institute (REMEDI) and College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland.
Curr Opin Organ Transplant. 2014 Feb;19(1):65-72. doi: 10.1097/MOT.0000000000000043.
Recent developments toward the successful clinical application of autologous and allogeneic mesenchymal stem cells (MSCs) to organ transplantation are summarized with a focus on safety and efficacy.
Clinical trials in organ transplantation and other conditions indicate that infusion of autologous or allogeneic MSCs is generally well tolerated. However, new studies also suggest that efficacy may be curtailed by sequestration in the lungs and early elimination. Safety concerns regarding autologous and/or allogeneic MSCs that have recently been investigated include transient proinflammatory effects, influences on opportunistic infections and cancers and alloantibody induction. Animal models indicate that autologous MSCs are likely to be efficacious in preventing or treating early intragraft inflammation and may reduce the risk of acute rejection - observations that have been borne out in a randomized controlled trial of living-donor kidney transplantation. The potential for donor-specific or third-party allogeneic MSCs to promote allograft tolerance is suggested by animal model studies but has not yet been proven in humans.
Recent reports on the safety and efficacy of autologous MSCs for early posttransplant outcomes give cause for optimism. Benefits of allogeneic MSCs for long-term allograft survival and of MSCs for chronic transplant injury await clinical validation.
自体和同种异体间充质干细胞（MSCs）向器官移植成功临床应用的最新进展，重点关注安全性和有效性。
器官移植和其他疾病的临床试验表明，输注自体或同种异体 MSCs 通常具有良好的耐受性。然而，新的研究也表明，由于在肺部的隔离和早期清除，疗效可能会受到限制。最近研究的关于自体和/或同种异体 MSCs 的安全性问题包括短暂的促炎作用、对机会性感染和癌症以及同种异体抗体诱导的影响。动物模型表明，自体 MSCs 可能在预防或治疗早期移植物内炎症方面有效，并可能降低急性排斥反应的风险——这些观察结果在活体供肾移植的随机对照试验中得到了证实。动物模型研究表明，供体特异性或第三方同种异体 MSCs 具有促进同种异体移植物耐受的潜力，但尚未在人类中得到证实。
最近关于自体 MSCs 用于移植后早期结局的安全性和有效性的报告令人乐观。同种异体 MSCs 对长期移植物存活的益处和 MSCs 对慢性移植损伤的益处有待临床验证。
