Medical and Biomedical Researches

Preoperative treatment of a presensitized kidney transplant recipient with donor-derived transplant

Preoperative treatment of a presensitized kidney transplant recipient with donor-derived transplant acceptance-inducing cells.

This report describes the case of patient FR, a 31-year-old recipient of a living-related kidney transplant from a donor against whom he was presensitized. Seventeen days prior to transplantation, a central venous infusion of transplant acceptance-inducing cells (TAICs) was administered to the patient. During the 27-month follow up, the patient experienced no acute rejection episodes under an immunosuppressive regime comprising anti-thymocyte globulin (ATG) induction, corticosteroids and tacrolimus. In a similar manner to the kidney transplant recipients treated preoperatively with TAICs in a previous study, patient FR achieved a state of donor-specific hypo-responsiveness. Most remarkably, the deliberate preoperative exposure of a sensitized patient to the sensitizing alloantigen did not heighten his response; on the contrary, after TAIC treatment and transplantation, HLA-specific antibodies were no longer detectable. The case of patient FR provides further evidence of the safety of pre-transplantation treatment with TAICs.

Hutchinson JA, Roelen D, Riquelme P, Brem-Exner BG, Witzke O, Philipp T, Matthäi M, Gövert F, Claas FH, Westphal E, Kunzendorf U, Geissler EK, Fändrich F.

Laboratory of Transplantation Research of the Clinic of General and Thoracic Surgery, University of Schleswig-Holstein, Kiel, Germany.