Brief Communication
The Role of Donor Bone Marrow Infusions in Withdrawal of Immunosuppression in Adult Liver Allotransplantation

https://doi.org/10.1111/j.1600-6143.2004.00743.xGet rights and content
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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was reduced by one third upon enrollment, by another third the second year of the study and was completely withdrawn the third year.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.

Key words:

Donor bone narrow infusion
immunosuppression withdrawal
liver transplantation
tolerance

Abbreviations:

HCV
hepatitis C virus
HBV
hepatitis B virus
FHF
fulminant hepatic failure
A1A
a1 anti-trypsine deficiency
G1
group 1 (study group who received donor bone marrow cell infusions early posttransplantation)
G2
Group 2 (control group, who did not receive donor bone marrow cell infusions);
DBMC
donor bone marrow cells
MMF
mycopheno-late mofetil
SE
standard error

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Copyright © 2005 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved. Published by Elsevier B.V. All rights reserved.