July 8, 2012

Tolerance and Withdrawal of Immunosuppressive Drugs in Patients Given Kidney and Hematopoietic Cell Transplants

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While tolerance is one of the ultimate goals for transplantation, there have been few studies rigorously attempting tolerogenic protocols. This paper reports the results of an attempt to induce tolerance using a combination of total lymphoid radiation, thymoglobulin and donor bone-marrow cell infusion in recipients of very closely HLA-matched kidneys. Immunosuppression was completely withdrawn in 11 of 16 patients, but 3 patients did experience mild acute cellular rejection. The regimen was well-tolerated, and some patients have remained off all immunosuppression two years or more.

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