PMID- 21666482
OWN - NLM
STAT- MEDLINE
DCOM- 20111115
LR  - 20211020
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Print)
IS  - 1087-2418 (Linking)
VI  - 16
IP  - 4
DP  - 2011 Aug
TI  - Preclinical and clinical studies on the induction of renal allograft tolerance 
      through transient mixed chimerism.
PG  - 366-71
LID - 10.1097/MOT.0b013e3283484b2c [doi]
AB  - PURPOSE OF REVIEW: The present review updates the current status of research for 
      induction of tolerance through a mixed chimerism approach in nonhuman primates 
      and humans. RECENT FINDINGS: Allograft tolerance has been successfully achieved 
      with a nonmyeloablative conditioning regimen and donor bone marrow 
      transplantation in human leukocyte antigen (HLA)-matched and mismatched kidney 
      transplantation. In HLA-matched kidney transplantation, persistent mixed 
      chimerism and renal allograft tolerance has been achieved in some patients. In 
      HLA-mismatched combinations, induction of persistent mixed chimerism has not been 
      achieved using a nonmyeloablative preparative regimen. Nevertheless, the 
      transient mixed chimerism that has been achieved has resulted in long-term renal 
      allograft tolerance in the majority of patients. Recent preclinical studies have 
      demonstrated that the presence of heterologous memory T-cell responses observed 
      in primates, but not in rodents, may be a major barrier for induction of durable 
      chimerism and tolerance in primates. Strategies to overcome such memory T-cell 
      responses may, therefore, be of great value in the development of reliable 
      protocols for clinical tolerance induction. SUMMARY: Induction of tolerance in 
      clinical kidney transplantation has been achieved via mixed chimerism approaches. 
      Improvements in the consistency and safety of tolerance induction and extension 
      of successful protocols to other organs and to organs from deceased donors will 
      all be among the next steps in bringing tolerance to a wider range of clinical 
      applications.
FAU - Kawai, Tatsuo
AU  - Kawai T
AD  - Transplant Center, Department of Surgery, Massachusetts General Hospital, Boston, 
      Massachusetts 02129, USA.
FAU - Cosimi, A Benedict
AU  - Cosimi AB
FAU - Sachs, David H
AU  - Sachs DH
LA  - eng
GR  - N01 AI1541/AI/NIAID NIH HHS/United States
GR  - U19 AI102405/AI/NIAID NIH HHS/United States
GR  - U01 DK080653/DK/NIDDK NIH HHS/United States
GR  - N01 AI015416/AI/NIAID NIH HHS/United States
GR  - 1U19DK080652-01/DK/NIDDK NIH HHS/United States
GR  - U19 DK080652/DK/NIDDK NIH HHS/United States
GR  - U01 DK080653-04/DK/NIDDK NIH HHS/United States
GR  - U19 DK080652-04/DK/NIDDK NIH HHS/United States
GR  - 5U01DK080653-04/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
PL  - United States
TA  - Curr Opin Organ Transplant
JT  - Current opinion in organ transplantation
JID - 9717388
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Animals
MH  - Bone Marrow Transplantation/*immunology
MH  - *Graft Survival
MH  - HLA Antigens/immunology
MH  - Histocompatibility
MH  - Humans
MH  - Immunologic Memory
MH  - Kidney Transplantation/*immunology
MH  - Primates
MH  - T-Lymphocytes/immunology
MH  - *Transplantation Chimera
MH  - *Transplantation Tolerance
MH  - Transplantation, Homologous
MH  - Treatment Outcome
PMC - PMC3151013
MID - NIHMS313361
EDAT- 2011/06/15 06:00
MHDA- 2011/11/16 06:00
PMCR- 2012/08/01
CRDT- 2011/06/14 06:00
PHST- 2011/06/14 06:00 [entrez]
PHST- 2011/06/15 06:00 [pubmed]
PHST- 2011/11/16 06:00 [medline]
PHST- 2012/08/01 00:00 [pmc-release]
AID - 10.1097/MOT.0b013e3283484b2c [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2011 Aug;16(4):366-71. doi: 
      10.1097/MOT.0b013e3283484b2c.