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第三届临床耐受国际研讨会摘要。

Summary of the Third International Workshop on Clinical Tolerance.

机构信息

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Department of Surgery, Northwestern University School of Medicine, Chicago, IL, USA.

出版信息

Am J Transplant. 2019 Feb;19(2):324-330. doi: 10.1111/ajt.15086. Epub 2018 Oct 1.

Abstract

The Third International Workshop on Clinical Tolerance was held in Stanford, California, September 8-9, 2017. This is a summary of Workshop presentations of clinical trials designed to withdraw or minimize immunosuppressive (IS) drugs in kidney and liver transplant patients without subsequent evidence of rejection. All clinical protocols had in common the use of donor or recipient cell therapy combined with organ transplantation. Tolerance to HLA matched and mismatched living donor kidney transplants with complete withdrawal of IS drugs without subsequent rejection for up to 14 years of observation was achieved in more than 50 patients enrolled in trials in four medical centers after the establishment of transient or persistent chimerism. Complete IS drug withdrawal without chimerism was reported in a prospective trial of liver transplantation combined with injection of regulatory T cells. IS drug minimization without rejection was reported in recipients of living donor kidney transplants enrolled in the One Study consortium after injection of recipient regulatory T cells, or injection of donor regulatory monocytes or dendritic cells. In conclusion, considerable progress has been made in achieving IS drug withdrawal after cell therapy in recipients of organ transplants.

摘要

第三届临床耐受国际研讨会于 2017 年 9 月 8 日至 9 日在加利福尼亚州斯坦福举行。这是为在器官移植受者中撤除非免疫抑制(IS)药物而不随后发生排斥反应的临床试验的研讨会报告摘要。所有临床方案都有一个共同点,即使用供体或受体细胞治疗与器官移植相结合。在四个医疗中心进行的试验中,有 50 多名患者在建立短暂或持续嵌合体后,成功实现了对 HLA 匹配和不匹配的活体供肾移植的耐受,完全撤除非 IS 药物而不随后发生排斥反应,观察时间长达 14 年。在一项前瞻性肝移植联合调节性 T 细胞注射的试验中,报告了无嵌合体的完全 IS 药物撤药。在 One Study 联盟中接受活体供肾移植的受者中,报告了无排斥反应的 IS 药物最小化,这些受者接受了受者调节性 T 细胞的注射,或接受了供者调节性单核细胞或树突状细胞的注射。总之,在接受器官移植的受者中,通过细胞治疗实现 IS 药物撤药方面已经取得了相当大的进展。

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