Transient-mixed Chimerism With Nonmyeloablative Conditioning Does Not Induce Liver Allograft Tolerance in Nonhuman Primates.

Autor:	Chaudhry S; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Surgery, Columbia University Irving Medical Center, New York, NY., Kato Y; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Surgery, Columbia University Irving Medical Center, New York, NY., Weiner J; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Surgery, Columbia University Irving Medical Center, New York, NY., Alonso-Guallart P; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Baker S; Institute of Comparative Medicine, Columbia University Irving Medical Center, New York, NY.; Veterinary Service Center, Stanford University, Stanford, CA., Woodland DC 4th; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Lefkowitch JH; Department of Pathology, Columbia University Irving Medical Center, New York, NY., Duran-Struuck R; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA., Sondermeijer HP; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Zitsman J; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Sears ML; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Wu A; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY., Karolewski B; Institute of Comparative Medicine, Columbia University Irving Medical Center, New York, NY., Houck PJ; Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY., Martinez M; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Pediatrics, Columbia University Irving Medical Center, New York, NY., Kato T; Department of Surgery, Columbia University Irving Medical Center, New York, NY., Sykes M; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Surgery, Columbia University Irving Medical Center, New York, NY.; Department of Medicine, Columbia University Irving Medical Center, New York, NY.; Department of Microbiology & Immunology, Columbia University Irving Medical Center, New York, NY., Griesemer AD; Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, NY.; Department of Surgery, Columbia University Irving Medical Center, New York, NY.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2020 Aug; Vol. 104 (8), pp. 1580-1590.
DOI:	10.1097/TP.0000000000003263
Abstrakt:	Background: Although short-term outcomes for liver transplantation have improved, patient and graft survival are limited by infection, cancer, and other complications of immunosuppression. Rapid induction of tolerance after liver transplantation would decrease these complications, improving survival and quality of life. Tolerance to kidneys, but not thoracic organs or islets, has been achieved in nonhuman primates and humans through the induction of transient donor chimerism. Since the liver is considered to be tolerogenic, we tested the hypothesis that the renal transplant transient chimerism protocol would induce liver tolerance. Methods: Seven cynomolgus macaques received immune conditioning followed by simultaneous donor bone marrow and liver transplantation. The more extensive liver surgery required minor adaptations of the kidney protocol to decrease complications. All immunosuppression was discontinued on postoperative day (POD) 28. Peripheral blood chimerism, recipient immune reconstitution, liver function tests, and graft survival were determined. Results: The level and duration of chimerism in liver recipients were comparable to those previously reported in renal transplant recipients. However, unlike in the kidney model, the liver was rejected soon after immunosuppression withdrawal. Rejection was associated with proliferation of recipient CD8 T effector cells in the periphery and liver, increased serum interleukin (IL)-6 and IL-2, but peripheral regulatory T cell (Treg) numbers did not increase. Antidonor antibody was also detected. Conclusions: These data show the transient chimerism protocol does not induce tolerance to livers, likely due to greater CD8 T cell responses than in the kidney model. Successful tolerance induction may depend on greater control or deletion of CD8 T cells in this model.
Databáze:	MEDLINE
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