PMID- 27805947
OWN - NLM
STAT- MEDLINE
DCOM- 20170905
LR  - 20181202
IS  - 1531-7013 (Electronic)
IS  - 1087-2418 (Linking)
VI  - 21
IP  - 6
DP  - 2016 Dec
TI  - Bone marrow chimerism as a strategy to produce tolerance in solid organ 
      allotransplantation.
PG  - 595-602
AB  - PURPOSE OF REVIEW: Clinical transplant tolerance has been most successfully 
      achieved combining hematopoietic chimerism with kidney transplantation. This 
      review outlines this strategy in animal models and human transplantation, and 
      possible clinical challenges. RECENT FINDINGS: Kidney transplant tolerance has 
      been achieved through chimerism in several centers beginning with Massachusetts 
      General Hospital's success with mixed chimerism in human leukocyte antigen 
      (HLA)-mismatched patients and the Stanford group with HLA-matched patients, and 
      the more recent success of the Northwestern protocol achieving full chimerism. 
      This has challenged the original view that stable mixed chimerism is necessary 
      for organ graft tolerance. However, among the HLA-mismatched kidney 
      transplant-tolerant patients, loss of mixed chimerism does not lead to 
      renal-graft rejection, and the development of host Foxp3+ regulatory T cells has 
      been observed. Recent animal models suggest that graft tolerance through bone 
      marrow chimerism occurs through both clonal deletion and regulatory immune cells. 
      Further, Tregs have been shown to improve chimerism in animal models. SUMMARY: 
      Animal studies continue to suggest ways to improve our current clinical 
      strategies. Advances in chimerism protocols suggest that tolerance may be 
      clinically achievable with relative safety for HLA-mismatched kidney transplants.
FAU - Hu, Min
AU  - Hu M
AD  - aCentre for Transplantation and Renal Research, Westmead Institute for Medical 
      Research bCentre for Kidney Research, The Children's Hospital at Westmead, 
      University of Sydney, Westmead, NSW, Australia.
FAU - Alexander, Stephen I
AU  - Alexander SI
FAU - Yi, Shounan
AU  - Yi S
LA  - eng
PT  - Journal Article
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 Cells/cytology/physiology
MH  - Bone Marrow Transplantation
MH  - HLA Antigens
MH  - Humans
MH  - *Kidney Transplantation
MH  - *Transplantation Chimera
MH  - *Transplantation Tolerance
EDAT- 2016/11/03 06:00
MHDA- 2017/09/07 06:00
CRDT- 2016/11/03 06:00
PHST- 2016/11/03 06:00 [pubmed]
PHST- 2017/09/07 06:00 [medline]
PHST- 2016/11/03 06:00 [entrez]
AID - 00075200-201612000-00009 [pii]
AID - 10.1097/MOT.0000000000000366 [doi]
PST - ppublish
SO  - Curr Opin Organ Transplant. 2016 Dec;21(6):595-602. doi: 
      10.1097/MOT.0000000000000366.