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A clinical trial combining donor bone marrow infusion and heart transplantation: intermediate-term results.

Pham, SM and Rao, AS and Zeevi, A and Kormos, RL and McCurry, KR and Hattler, BG and Fung, JJ and Starzl, TE and Griffith, BP (2000) A clinical trial combining donor bone marrow infusion and heart transplantation: intermediate-term results. J Thorac Cardiovasc Surg, 119 (4 Pt 1). 673 - 681. ISSN 0022-5223

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Abstract

BACKGROUND: Donor chimerism (the presence of donor cells of bone marrow origin) is present for years after transplantation in recipients of solid organs. In lung recipients, chimerism is associated with a lower incidence of chronic rejection. To augment donor chimerism with the aim to enhance graft acceptance and to reduce immunosuppression, we initiated a trial combining infusion of donor bone marrow with heart transplantation. Reported herein are the intermediate-term results of this ongoing trial. METHODS: Between September 1993 and August 1998, 28 patients received concurrent heart transplantation and infusion of donor bone marrow at 3.0 x 10(8) cells/kg (study group). Twenty-four contemporaneous heart recipients who did not receive bone marrow served as controls. All patients received an immunosuppressive regimen consisting of tacrolimus and steroids. RESULTS: Patient survival was similar between the study and control groups (86% and 87% at 3 years, respectively). However, the proportion of patients free from grade 3A rejection was higher in the study group (64% at 6 months) than in the control group (40%; P =.03). The prevalence of coronary artery disease was similar between the two groups (freedom from disease at 3 years was 78% in study patients and 69% in controls). Similar proportions of study (18%) and control (15%) patients exhibited in vitro evidence of donor-specific hyporesponsiveness. CONCLUSIONS: The infusion of donor bone marrow reduces the rate of acute rejection in heart recipients. Donor bone marrow may play an important role in strategies aiming to enhance the graft acceptance.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pham, SM
Rao, AS
Zeevi, A
Kormos, RL
McCurry, KR
Hattler, BG
Fung, JJ
Starzl, TEtes11@pitt.eduTES11
Griffith, BP
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: April 2000
Date Type: Publication
Journal or Publication Title: J Thorac Cardiovasc Surg
Volume: 119
Number: 4 Pt 1
Page Range: 673 - 681
DOI or Unique Handle: 10.1016/s0022-5223(00)70001-8
Institution: University of Pittsburgh
Refereed: Yes
Uncontrolled Keywords: Acute Disease, Bone Marrow Transplantation, Cell Transplantation, Female, Graft Enhancement, Immunologic, Graft Rejection, Heart Transplantation, Histocompatibility Antigens Class I, Humans, Immunosuppressive Agents, Lymphocyte Culture Test, Mixed, Male, Middle Aged, Prospective Studies, Transplantation Chimera
ISSN: 0022-5223
Funders: None (A-3176), NIAID NIH HHS (AI40329)
Other ID: uls-drl:31735062120302, Starzl CV No. 2122
Date Deposited: 08 Apr 2010 17:36
Last Modified: 13 Oct 2017 17:55
URI: http://d-scholarship.pitt.edu/id/eprint/5508

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