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Titolo:
MICROCHIMERISM AND REJECTION IN CLINICAL TRANSPLANTATION
Autore:
ELWOOD ET; LARSEN CP; MAURER MH; ROUTENBERG KL; NEYLAN NF; WHELCHEL JD; OBRIEN DP; PEARSON TC;
Indirizzi:
EMORY UNIV,SCH MED,DEPT SURG,ROOM 5105 WMB,1639 PIERCE DR ATLANTA GA 30322 EMORY UNIV,SCH MED,DEPT SURG ATLANTA GA 30322 EMORY UNIV,SCH MED,DEPT MED ATLANTA GA 30322 EMORY UNIV,SCH MED,DEPT PATHOL ATLANTA GA 30322
Titolo Testata:
Lancet
fascicolo: 9062, volume: 349, anno: 1997,
pagine: 1358 - 1360
SICI:
0140-6736(1997)349:9062<1358:MARICT>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALLOGRAFT RECIPIENTS; GRAFT ACCEPTANCE; CELL-MIGRATION; CHIMERISM; KIDNEY; LIVER; TOLERANCE; HEART; PCR;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
E.T. Elwood et al., "MICROCHIMERISM AND REJECTION IN CLINICAL TRANSPLANTATION", Lancet, 349(9062), 1997, pp. 1358-1360

Abstract

Background Haemopoietic microchimerism has been identified in recipients of solid-organ transplants and is thought by some to be critical for the development and maintenance of immunological tolerance. The aimof this study was to correlate prospectively the persistence of donorcells with clinical outcome in recipients of kidney, kidney and pancreas, and liver transplants. Methods Persistence of donor cells in recipient peripheral blood was assessed at. 3 days, and at 1, 3, 6, and 12months after transplantation by a two-stage nested PCR technique to detect donor MHC HLA DR gene specifically, A pretransplant blood samplewas collected from each patient to serve as an individual negative control, Seven liver, six kidney and pancreas, and 17 kidney patients were enrolled, 12 of the 17 kidney patients and all of the kidney and pancreas, and liver recipients were suitable for analysis. Exact matchesfor donors and recipients at the HLA DR loci (n=1) or inability to obain primer pair specificity among similar HLA DR types (n=4), meant that we were unable to analyse five patients. Findings Donor DNA was detected in 20 (80%) of 25,ten (40%) of 25, seven (30%) of 23, five (22%)of 23, and six (32%) of 19 recipients at 3 days, and 1, 3, 6 and 12 months post-transplant, respectively. Within individuals, the detectionof donor DNA varied over time; only two patients had detectable donorDNA at all times. Analysis of the whole group of transplant patients showed a similar frequency and severity of rejection episodes in patients with and without microchimerism as defined by detectable donor DR genes. Interpretation These data suggest that a significant percentageof the recipients had persistent donor class II DNA in the peripheralcirculation for at least 1 year after transplantation, We showed thata pretransplant blood sample is critical to avoid a false-positive result, and suggest that detectable chimerism may vary over time in individual patients, Therefore, analysis of microchimerism with a single, post-transplant analysis may not help in malting clinical decisions for individual patients.

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Documento generato il 29/03/20 alle ore 18:15:02