The Role of Donor Bone Marrow Infusions in Withdrawal of Immunosuppression in Adult Liver Allotransplantation |
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| Authors: | Panagiotis Tryphonopoulos reas G Tzakis Debbie Weppler Rolando Garcia-Morales Tomoaki Kato Juan R Madariaga David M Levi Seigo Nishida Jang Moon Gennaro Selvaggi Arie Regev Caio Nery Pablo Bejarano Amr Khaled Gary Kleiner Violet Esquenazi Joshua Miller Philip Ruiz Camillo Ricordi |
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| Institution: | Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, Florida, USA. |
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| Abstract: | We investigated the role of donor bone marrow cell (DBMC) infusions in immunosuppression withdrawal in adult liver transplantation. Patients enrolled were at least 3 years post-transplantation, with stable graft function. Forty-five (study group: G1) received DBMC, and 59 (control group: G2) did not. Immunosuppression was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year. Patient and graft survival were similar between the two groups. Although rejection episodes were significantly less in G1 the first 2 years of the study (35% vs. 57%, p = 0.016), there was no significant difference overall (74% vs. 81%, p = 0.14). Until February 2004, 20 patients, 10 in each group, were immunosuppression free for 1-3 years. Approximately 20% of long-term survivors of liver transplantation can successfully discontinue their immunosuppression. DBMC infusions, do not increase this likelihood. |
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| Keywords: | Donor bone narrow infusion immunosuppression withdrawl liver transplantation toi |
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