ArticleAnnals of surgery1999
Simultaneous administration of adjuvant donor bone marrow in pancreas transplant recipients.
Article in Annals of surgery, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 58 citations in OpenAlex.
- A clinical trial combining donor bone marrow infusion and heart transplantation: intermediate-term results.The Journal of thoracic and cardiovascular surgery · 2000Trial
- Characterization and Function of Cryopreserved Bone Marrow from Deceased Organ Donors: A Potential Viable Alternative Graft Source.Transplantation and cellular therapy · 2023Article
- Donor-specific tolerance induction in organ transplantation via mixed splenocytes chimerism.Clinical and experimental immunology · 2013Review
- Upper-extremity transplantation using a cell-based protocol to minimize immunosuppression.Annals of surgery · 2013Article
- Simultaneous bone marrow and composite tissue transplantation in rats treated with nonmyeloablative conditioning promotes tolerance.Transplantation · 2013Article
- Tolerance induction in HLA disparate living donor kidney transplantation by donor stem cell infusion: durable chimerism predicts outcome.Transplantation · 2013Article
- The immunomodulatory properties of mesenchymal stem cells: implications for surgical disease.The Journal of surgical research · 2011Review
- HLA-mismatched renal transplantation without maintenance immunosuppression.The New England journal of medicine · 2008Article
- Should we be performing more combined hematopoietic stem cell plus solid organ transplants?Bone marrow transplantation · 2003Review
- Pancreas and islet cell transplantation.Best practice & research. Clinical gastroenterology · 2002Review
- Lessons learned from more than 1,000 pancreas transplants at a single institution.Annals of surgery · 2001Review
- Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor.Annals of surgery · 2000Article
- Results of pancreas transplantation after steroid withdrawal under tacrolimus immunosuppression.Transplantation · 2000Article
- Kidney transplantation with bone marrow augmentation: five-year outcomes.Transplantation proceedingsArticle
- Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe effect of donor bone marrow was evaluated for its potentially favorable effect in the authors' simultaneous pancreas/kidney transplant program.
methodsFrom July 1994 to January 1999, 177 pancreas transplants were performed, 151 of which were simultaneous pancreas/kidney transplants. All patients received tacrolimus, mycophenolate mofetil, and steroids for immunosuppression (azathioprine was used in the first year of the program). Fifty-three simultaneous pancreas/kidney transplant recipients received perioperative unmodified donor bone marrow, 3 to 6 x 10(8) cells/kg.
resultsOverall actuarial survival rates at 1 and 3 years were 98% and 95% (patient), 95% and 87% (kidney), and 86% and 80% (pancreas), respectively. In the adjuvant bone marrow group, 1- and 3-year survival rates were 96% and 91 % (patient), 95% and 87% (kidney), and 83% and 83% (pancreas), respectively. For 98 recipients who did not receive bone marrow, survival rates at 1 and 3 years were 100% and 98% (patient), 96% and 86% (kidney), and 87% and 79% (pancreas), respectively. No pancreas allografts were lost after 3 months in bone marrow recipients, and seven in the non-bone marrow recipients were lost to rejection at 0.7, 6.7, 8.8, 14.6, 24.1, 24.3, and 25.5 months. Twenty-two percent of bone marrow patients were steroid-free at 1 year, 45% at 2 years, and 67% at 3 years. Nineteen percent of the non-bone marrow recipients were steroid-free at 1 year, 38% at 2 years, and 45% (p = 0.02) at 3 years. The mean acute cellular rejection rate was 0.94+/-1.1 in the bone marrow group and 1.57+/-1.3 (p = 0.003) in the non-bone marrow group (includes borderline rejection and multiple rejections). The level of donor cell chimerism in the peripheral blood of bone marrow patients was at least two logs higher than in controls.
conclusionIn this series, which represents the largest experience with adjuvant bone marrow infusion in pancreas recipients, there was a higher steroid withdrawal rate (p = 0.02), fewer rejection episodes, and no pancreas graft loss after 3 months in bone marrow recipients compared with contemporaneous controls. All pancreas allografts lost to chronic rejection (n = 6) were in the non-bone marrow group. Donor bone marrow administered around the time of surgery may have a protective effect in pancreas transplantation.
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