Selvaggi G, Ricordi C, Bottino R, Tzakis A G
Diabetes Research Institute, Cell Transplant Center, Miami, FL 33136, USA.
Ital J Gastroenterol. 1996 May;28(4):246-9.
It has been hypothesized that a state of microchimerism in recipients of organ transplants may result in donor-specific tolerance to the graft. Numerous studies show that infusion of donor-derived bone marrow cells can, indeed, achieve systemic chimerism in the recipient and effectively prolong allograft survival. We have compared organ and patient survival in recipients of liver allografts alone (controls) or in combination with single or multiple infusions of donor bone marrow cells; recipients were infused either at day 0 (perioperatively) or at day 0 and 11 post-transplant. The incidence of rejection episodes and survival of the liver allograft were significantly reduced in recipients of two bone marrow infusions compared to controls; recipients of one infusion, conversely, experienced a higher number of rejection episodes when compared to controls, pointing to a possible sensitizing role of a single bone marrow infusion if administered perioperatively. Variables such as timing, number and composition of the bone marrow inocula still remain to be elucidated but may be of critical importance for the attainment of a state of donor-specific tolerance without the need for immunosuppressive therapy in recipients of organ allografts.
有假说认为，器官移植受者体内的微嵌合状态可能导致对移植物产生供体特异性耐受。大量研究表明，输注供体来源的骨髓细胞确实能够在受者体内实现全身嵌合，并有效延长同种异体移植物的存活时间。我们比较了单纯接受肝脏同种异体移植的受者（对照组）以及接受单次或多次输注供体骨髓细胞的受者的器官和患者存活情况；受者在第0天（围手术期）或移植后第0天和第11天接受输注。与对照组相比，接受两次骨髓输注的受者排斥反应的发生率和肝脏同种异体移植物的存活率显著降低；相反，与对照组相比，接受一次输注的受者经历了更多的排斥反应，这表明围手术期进行单次骨髓输注可能具有致敏作用。骨髓接种物的时间、数量和组成等变量仍有待阐明，但对于在器官同种异体移植受者中无需免疫抑制治疗即可达到供体特异性耐受状态可能至关重要。
