unrelated living donor
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TRANSCRIPT
Effect of Living Unrelated Donor Bone Marrow Cell
Infusion on Kidney Allograft Function
Gholamreza Pourmand(1),Behrouz Nikbin(2),Abdolrasoul Mehrsai(1),Mohsen Taherimahmodi(1),Amir Asadpour(1),Ghasem Solgi(2),Sepehr Salem(1),Hannaneh
Wahhabaghai(1) .
1-Urology Research Center ,Sina Hospital , Medical Sciences/University of Tehran, Tehran, Iran.2-Immunogenetic Research Center, Faculty of Medicine, Medical Sciences/University of Tehran, Tehran, Iran.
Objective
• To evaluate the effect of living unrelated donor bone marrow cell infusion on kidney allograft function.
Introduction
• Donor bone marrow infusion (DBMI) has been used in kidney transplantation with the idea of inducing specific immunological unresponsiveness and augmenting the survival of solid organ transplantation.
Materials & Methods
-Nov 2006 to Jul 2007-40 patients:*20 Cases received(150-200cc) concurrent infusion of living unrelated donor bone marrow
*20 controls received transplant alone
Follow up:7 months prospectively
Materials & Methodscontinued
• immunosuppressive regimen: Cyclosporine A, cellcept, and prednisolone
• Follow up evaluation : Serum creatinine level(2 weeks daily then monthly)Necessity of using ATGDelayed graft function (DGF) acute rejection Episodes
Results
Mean serum creatinine(mg/dl)
First 2 weeks 3 weeks to 7 month
DBMI 2.62 1.18
Control 2.34 1.16
Results
Acute Rejection
DGF ATG
DBMI 8(40%) 7(35%) 5(25%)
Control 5(25%) 5(25%) 4(20%)
Results
• Clinical presentations of acute rejection such as fever ,graft tenderness and etc were more severe in control group;however, it was not statistically significant.
• Big lymphocelles required intervention in 3 patients of DBMI group(p≤0.01)and resolved with minimal intervention.
Conclusions
• Infusion of DBM cells was perfectly tolerated.• Decreasing of creatinine level in DBMI groups
was slower than control group; however, clinical presentations seemed more severe in control group.
• Further well-designed studies with large sample size and long-term follow up are warranted.