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Volume 358:362-368 January 24, 2008 Number 4
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Tolerance and Chimerism after Renal and Hematopoietic-Cell Transplantation
John D. Scandling, M.D., Stephan Busque, M.D., Sussan Dejbakhsh-Jones, M.S., Claudia Benike, B.S., Maria T. Millan, M.D., Judith A. Shizuru, M.D., Ph.D., Richard T. Hoppe, M.D., Robert Lowsky, M.D., Edgar G. Engleman, M.D., and Samuel Strober, M.D.

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 by Starzl, T. E.

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SUMMARY

We describe a recipient of combined kidney and hematopoietic-cell transplants from an HLA-matched donor. A post-transplantation conditioning regimen of total lymphoid irradiation and antithymocyte globulin allowed engraftment of the donor's hematopoietic cells. The patient had persistent mixed chimerism, and the function of the kidney allograft has been normal for more than 28 months since discontinuation of all immunosuppressive drugs. Adverse events requiring hospitalization were limited to a 2-day episode of fever with neutropenia. The patient has had neither rejection episodes nor clinical manifestations of graft-versus-host disease.


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From the Departments of Medicine (J.D.S., S.D.-J., J.A.S., R.L., S.S.), Surgery (S.B., M.T.M.), Pathology (C.B., E.G.E.), and Radiation Oncology (R.T.H.), Stanford University School of Medicine, Stanford, CA.

Address reprint requests to Dr. Strober at the Department of Medicine, Stanford University School of Medicine, Center for Clinical Science Research Bldg., Suite 2215, 269 W. Campus Dr., Stanford, CA 94305, or at sstrober{at}stanford.edu.

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