Evidence map›Paper›PMID 41110606›Full record

ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2026

Combined nonmyeloablative total lymphoid irradiation and low-dose total body irradiation enhances donor chimerism and leads to islet allograft acceptance.

Shiva Pathak, Bettina P Iliopoulou, Blake Mosher, Alexandra Wells, Levon Witherspoon, Cameron S Bader, Pin-I Chen, Shobha Regmi, Biki Gupta, Suparna Dutt and 7 more

Abstract read
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In one paragraph

Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Donor-derived CD8bioRxiv : the preprint server for biology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Shiva PathakDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Bettina P IliopoulouDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Blake MosherDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Alexandra WellsDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Levon WitherspoonDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Cameron S BaderDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Pin-I ChenDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Shobha RegmiDepartment of Pediatric Gastroenterology, Stanford University School of Medicine, Stanford, CA, USA.
Biki GuptaDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Suparna DuttDepartment of Medicine/Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, USA.
Xiangni WuDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Nadine NagyDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Kent P JensenDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA.
Avnesh S ThakorDepartment of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Sam StroberDepartment of Medicine/Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, USA.
Robert LowskyDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA.
Everett H MeyerDivision of Blood and Marrow Transplantation and Cellular Therapy, Stanford University School of Medicine, Stanford, CA, USA; Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA; Cellular Immune Tolerance Program, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: evmeyer@stanford.edu.

Funding

Stanford Islet Research CoreP30DK116074 · NIDDK · STANFORD UNIVERSITY · PI Seung K Kim · 2017 to 2026
$19.5M
cGMP Manufacture, Fill-Finish, Release, Analytical and Stability Testing and Stability Program of a Nanoparticle Based HIV Envelope Vaccine75N93022D00005 · NIAID · INTERNATIONAL AIDS VACCINE INITIATIVE · PI HASSELL, THOMAS · 2022 to 2025
$8.0M
Diabetes, Endocrinology and Metabolism Training GrantT32DK007217 · NIDDK · STANFORD UNIVERSITY · PI Justin Pierce Annes, David Matthew Maahs · 1987 to 2026
$7.2M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00005 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WATSON, KAROL E · 2020 to 2025
$5.1M
Engineered Immune Cells for T1DR01DK132549 · NIDDK · STANFORD UNIVERSITY · PI MEYER, EVERETT · 2022 to 2025
$3.1M
A stem cell activated cryogel bioscaffold that restores islet bioenergetics while providing oxygen and nutrients at extravascular sites of transplantationR01DK129343 · NIDDK · STANFORD UNIVERSITY · PI Avnesh Sinh Thakor · 2022 to 2026
$2.8M
Facilitating islet implantation and engraftment following transplantation using primed umbilical cord mesenchymal stem therapies and focused ultrasoundR01DK141802 · NIDDK · STANFORD UNIVERSITY · PI Avnesh Sinh Thakor · 2025 to 2026
$1.5M
30-parameter FACSymphony A3 flow cytometer for Shared Resource LabS10OD026831 · OD · STANFORD UNIVERSITY · PI NOLAN, GARRY P · 2019 to 2019
$510k
High-resolution tracking of T cell differentiation to predict and control alloreactive diseaseK99HL179392 · NHLBI · STANFORD UNIVERSITY · PI Cameron Scott Bader · 2025 to 2026
$262k
NHLBI NIH HHS 75N92020D00005NHLBI NIH HHS K99 HL179392NIAID NIH HHS 75N93022D00005NIAID NIH HHS 75N93023D00005NIDA NIH HHS 75N95020D00005NIDDK NIH HHS P30 DK116074NIDDK NIH HHS R01 DK129343NIDDK NIH HHS R01 DK132549NIDDK NIH HHS R01 DK141802NIDDK NIH HHS T32 DK007217NIH HHS S10 OD026831ORFDO NIH HHS 75N99020D00005
6 · The paper itself

Abstract

The nonmyeloablative conditioning regimen comprising total lymphoid irradiation (TLI) and antithymocyte globulin is used for allogeneic hematopoietic stem cell transplant patients. There is a need to safely intensify TLI+antithymocyte globulin to allow for the achievement of sustained mixed chimerism, particularly in cases where pre-existing autoimmunity poses a significant barrier to successful engraftment. We developed a nonmyeloablative immune preconditioning protocol using low-dose total body irradiation (TBI) to increase the level and durability of mixed donor chimerism. Non-obese diabetic mice were preconditioned with a modified protocol comprising TLI, low-dose TBI, and antithymocyte serum before bone marrow (BM) transplantation. The incorporation of low-dose TBI resulted in enhanced lymphodepletion and facilitated successful engraftment of allogeneic BM to create mixed donor chimerism. The establishment of mixed donor chimerism led to a long-term acceptance of transplanted pancreatic islets that were matched to the BM. More importantly, third-party islets from donors that were mismatched to both the recipient and BM donors were also accepted, highlighting the potency of tolerance induction using this preconditioning regimen. These results provide strong support for a rapid clinical evaluation of this modified conditioning regimen in the context of post-transplant tolerance induction.

Indexed as

Graft RejectionGraft SurvivalIslets of Langerhans TransplantationLymphatic IrradiationTransplantation ChimeraTransplantation ConditioningWhole-Body IrradiationAnimalsBone Marrow TransplantationMiceMice, Inbred BALB CMice, Inbred C57BLMice, Inbred NODTissue DonorsTransplantation, Homologouschimerismengraftment barrierHematopoietic stem cellsislet transplantationnonmyeloablative preconditioningtolerance

Identifiers

PMID41110606
PMCPMC12698175

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Registered trials

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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.