ArticleTransplantation2013
Tolerance induction in HLA disparate living donor kidney transplantation by donor stem cell infusion: durable chimerism predicts outcome.
Article in Transplantation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers.
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Who cites it
73 citing papers in PubMed, 152 citations in OpenAlex.
- Improved survival after transplantation of more donor plasmacytoid dendritic or naïve T cells from unrelated-donor marrow grafts: results from BMTCTN 0201.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2014Trial
- Preclinical and clinical studies on kidney allograft tolerance via hematopoietic chimerism.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Review
- Improved conditioning for hematopoietic chimerism induces islet tolerance to cure diabetes.JCI insight · 2026Article
- Article
- Immunosuppressive-Free Renal Allograft Function After Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report.Acta medica academica · 2025Article
- Tolerance Induction Strategies in Organ Transplantation: Current Status and Future Perspectives.Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- Chimerism-Mediated Tolerance in Intestinal Transplantation.Gastroenterology clinics of North America · 2024Review
- Physiological basis for xenotransplantation from genetically modified pigs to humans.Physiological reviews · 2024Review
- Tolerance in intestinal transplantation.Human immunology · 2024Review
- Differentiation of regulatory myeloid and T-cells from adult human hematopoietic stem cells after allogeneic stimulation.Frontiers in immunology · 2024Article
- Article
- Biomarkers of immune tolerance in kidney transplantation: an overview.Pediatric nephrology (Berlin, Germany) · 2022Review
- Progress in Xenotransplantation: Immunologic Barriers, Advances in Gene Editing, and Successful Tolerance Induction Strategies in Pig-To-Primate Transplantation.Frontiers in immunology · 2022Review
- Progress in islet xenotransplantation: Immunologic barriers, advances in gene editing, and tolerance induction strategies for xenogeneic islets in pig-to-primate transplantation.Frontiers in transplantation · 2022Article
- Clinical and preclinical tolerance protocols for vascularized composite allograft transplantation.Archives of plastic surgery · 2021Article
- Harnessing Mechanisms of Immune Tolerance to Improve Outcomes in Solid Organ Transplantation: A Review.Frontiers in immunology · 2021Review
- Chimerism-Based Tolerance to Kidney Allografts in Humans: Novel Insights and Future Perspectives.Frontiers in immunology · 2021Review
- Cellular Therapies in Solid Organ Allotransplantation: Promise and Pitfalls.Frontiers in immunology · 2021Review
- Tolerance induction with donor hematopoietic stem cell infusion in kidney transplantation: a single-center experience in China with a 10-year follow-up.Annals of translational medicine · 2020Article
- Mixed chimerism and acceptance of kidney transplants after immunosuppressive drug withdrawal.Science translational medicine · 2020Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundWe recently reported that durable chimerism can be safely established in mismatched kidney recipients through nonmyeloablative conditioning followed by infusion of a facilitating cell (FC)-based hematopoietic stem cell transplantation termed FCRx. Here we provide intermediate-term follow-up on this phase II trial.
methodsFifteen human leukocyte antigen-mismatched living donor renal transplant recipients underwent low-intensity conditioning (fludarabine, cyclophosphamide, 200 cGy TBI), received a living donor kidney transplant on day 0, then infusion of cryopreserved FCRx on day +1. Maintenance immunosuppression, consisting of tacrolimus and mycophenolate, was weaned over 1 year.
resultsAll but one patient demonstrated peripheral blood macrochimerism after transplantation. Engraftment failure occurred in a highly sensitized (panel reactive antibody [PRA] of 52%) recipient. Chimerism was lost in three patients at 2, 3, and 6 months after transplantation. Two of these subjects had received either a reduced cell dose or incomplete conditioning; the other two had PRA greater than 20%. All demonstrated donor-specific hyporesponsiveness and were weaned from full-dose immunosuppression. Complete immunosuppression withdrawal at 1 year after transplantation was successful in all patients with durable chimerism. There has been no graft-versus-host disease or engraftment syndrome. Renal transplantation loss occurred in one patient who developed sepsis following an atypical viral infection. Two subjects with only transient chimerism demonstrated subclinical rejection on protocol biopsy despite donor-specific hyporesponsiveness.
conclusionsLow-intensity conditioning plus FCRx safely achieved durable chimerism in mismatched allograft recipients. Sensitization represents an obstacle to successful induction of chimerism. Sustained T-cell chimerism is a more robust biomarker of tolerance than donor-specific hyporeactivity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.