OBJECTIVES: Donor specific antibodies (DSA) and a positive cross-match are contraindications for kidney transplantation. Trials of allograft transplantation across the HLA barrier have employed desensitization strategies, including the use of plasmapheresis, intravenous immunoglobulins, anti-B-cell monoclonal antibodies and splenectomy, associated with high-intensity immunosuppressive regimens. Our case 1 report suffered from repeatedly positive lymphocyte cross match after 1st renal transplantation. Graft nephrectomy could not correct the state of sensitization. Splenectomy was done in a trial to get rid of the antibody producing clone. Furthermore plasmapheresis with low dose IVIG could not as well revert the state of sensitization for the patient. MATERIAL AND METHODS: About 50 millions donor specific MSCs were injected to the patient. RESULTS: MSCs transfusion proved to be the only procedure which could achieve successful desensitization before performing the second transplantation owing to their immunosuppressive properties. CONCLUSION: This case indicates that DS-MSCs is a potential option for anti-HLA desensitization. In cases 2 and 3 IV DS-MSCs transfusion was selected from the start as a successful line of treatment for pre renal transplantation desensitization to save other unnecessary lines of treatment that were tried in case 1.
OBJECTIVES:Donor specific antibodies (DSA) and a positive cross-match are contraindications for kidney transplantation. Trials of allograft transplantation across the HLA barrier have employed desensitization strategies, including the use of plasmapheresis, intravenous immunoglobulins, anti-B-cell monoclonal antibodies and splenectomy, associated with high-intensity immunosuppressive regimens. Our case 1 report suffered from repeatedly positive lymphocyte cross match after 1st renal transplantation. Graft nephrectomy could not correct the state of sensitization. Splenectomy was done in a trial to get rid of the antibody producing clone. Furthermore plasmapheresis with low dose IVIG could not as well revert the state of sensitization for the patient. MATERIAL AND METHODS: About 50 millions donor specific MSCs were injected to the patient. RESULTS: MSCs transfusion proved to be the only procedure which could achieve successful desensitization before performing the second transplantation owing to their immunosuppressive properties. CONCLUSION: This case indicates that DS-MSCs is a potential option for anti-HLA desensitization. In cases 2 and 3 IV DS-MSCs transfusion was selected from the start as a successful line of treatment for pre renal transplantation desensitization to save other unnecessary lines of treatment that were tried in case 1.
Authors: Richard Poulsom; Evangelia I Prodromidi; Charles D Pusey; H Terence Cook Journal: Nephrol Dial Transplant Date: 2006-10-05 Impact factor: 5.992
Authors: Andrea Augello; Roberta Tasso; Simone Maria Negrini; Andrea Amateis; Francesco Indiveri; Ranieri Cancedda; Giuseppina Pennesi Journal: Eur J Immunol Date: 2005-05 Impact factor: 5.532
Authors: James M Gloor; Steven R DeGoey; Alvaro A Pineda; S Breanndan Moore; Mikel Prieto; Scott L Nyberg; Timothy S Larson; Matthew D Griffin; Stephen C Textor; Jorge A Velosa; Thomas R Schwab; Lynette A Fix; Mark D Stegall Journal: Am J Transplant Date: 2003-08 Impact factor: 8.086
Authors: D Glotz; J P Haymann; N Sansonetti; A Francois; V Menoyo-Calonge; J Bariety; P Druet Journal: Transplantation Date: 1993-08 Impact factor: 4.939
Authors: Daniel S Warren; Andrea A Zachary; Christopher J Sonnenday; Karen E King; Matthew Cooper; Lloyd E Ratner; R Sue Shirey; Mark Haas; Mary S Leffell; Robert A Montgomery Journal: Am J Transplant Date: 2004-04 Impact factor: 8.086