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Evidence for kidney rejection after combined bone marrow and renal transplantation despite ongoing whole-blood chimerism in rhesus macaques.

S K Ramakrishnan | A Page | A B Farris | K Singh | F Leopardi | K Hamby | S Sen | A Polnett | T Deane | M Song | L Stempora | E Strobert | A D Kirk | C P Larsen | L S Kean
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons | 2012

Although there is evidence linking hematopoietic chimerism induction and solid organ transplant tolerance, the mechanistic requirements for chimerism-induced tolerance are not clearly elucidated. To address this, we used an MHC-defined primate model to determine the impact of impermanent, T cell-poor, mixed-chimerism on renal allograft survival. We compared two cohorts: one receiving a bone marrow and renal transplant ("BMT/renal") and one receiving only a renal transplant. Both cohorts received maintenance immunosuppression with CD28/CD40-directed costimulation blockade and sirolimus. As previously demonstrated, this transplant strategy consistently induced compartmentalized donor chimerism, (significant whole-blood chimerism, lacking T cell chimerism). This chimerism was not sufficient to prolong renal allograft acceptance: the BMT/renal mean survival time (MST, 76 days) was not significantly different than the renal transplant alone MST (85 days, p = 0.46), with histopathology documenting T cell mediated rejection. Flow cytometric analysis revealed significant enrichment for CD28-/CD95+ CD4+ and CD8+ Tem cells in the rejected kidney, suggesting a link between CD28-negative Tem and costimulation blockade-resistant rejection. These results suggest that in some settings, transient T cell-poor chimerism is not sufficient to induce tolerance to a concurrently placed renal allograft and that the presence of this chimerism per se is not an independent biomarker to identify tolerance.

Pubmed ID: 22642491

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Associated grants

  • Agency: NHLBI NIH HHS, United States
    Id: R01 HL095791
  • Agency: NIAID NIH HHS, United States
    Id: 5K08 AI065822
  • Agency: NIAID NIH HHS, United States
    Id: U19 AI051731
  • Agency: NIAID NIH HHS, United States
    Id: HHSN272200900037C
  • Agency: NCRR NIH HHS, United States
    Id: P51 RR000165
  • Agency: NCRR NIH HHS, United States
    Id: U24 RR018109
  • Agency: NIAID NIH HHS, United States
    Id: U01 AI079223
  • Agency: NHLBI NIH HHS, United States
    Id: R01 HL095791-02
  • Agency: NIAID NIH HHS, United States
    Id: U19 AI051731-10
  • Agency: NIAID NIH HHS, United States
    Id: 1U01AI079223
  • Agency: NCRR NIH HHS, United States
    Id: RR00165
  • Agency: NIAID NIH HHS, United States
    Id: K08 AI065822
  • Agency: NIAID NIH HHS, United States
    Id: 5U19 AI051731
  • Agency: NHLBI NIH HHS, United States
    Id: 1R01 HL095791

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Nonhuman Primate Reagent Resource (antibody supplier)

RRID:SCR_012986

Center that facilitates the optimal use of nonhuman primate models in biomedical research by identifying, developing, characterizing and producing reagents for monitoring or modulating immune responses. They distribute non-human primate-specific antibodies for in vitro diagnostics, as well as develop and produce primate recombinant antibodies for in vivo cell depletion or modulating immune responses.

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Nonhuman Primate Reagent Resource (antibody supplier)

RRID:SCR_012986

Center that facilitates the optimal use of nonhuman primate models in biomedical research by identifying, developing, characterizing and producing reagents for monitoring or modulating immune responses. They distribute non-human primate-specific antibodies for in vitro diagnostics, as well as develop and produce primate recombinant antibodies for in vivo cell depletion or modulating immune responses.

View all literature mentions