Langenbeck's Archives of Surgery

, Volume 400, Issue 5, pp 541–550 | Cite as

Cell therapy for immunosuppression after kidney transplantation

  • Christian MorathEmail author
  • Anita Schmitt
  • Martin Zeier
  • Michael Schmitt
  • Flavius Sandra-Petrescu
  • Gerhard Opelz
  • Peter Terness
  • Matthias Schaier
  • Christian KleistEmail author
Review Article



To give an overview over cell therapeutic approaches to immunosuppression in clinical kidney transplantation. A focus is on myeloid suppressor cell therapy by mitomycin C-induced cells (MICs).


Literature review with an emphasis on already existing therapies.


Several cell therapeutic approaches to immunosuppression and donor-specific unresponsiveness are now being tested in early phase I and phase II trials in clinical kidney transplantation. Cell products such as regulatory T cells or regulatory macrophages, or other myeloid suppressor cell therapies, may either consist of donor-specific, third-party, or autologous cell preparations. Major problems are the identification of the suppressive cell populations and their expansion to have sufficient amount of cells to achieve donor unresponsiveness (e.g., with regulatory T cells). We show a simple and safe way to establish donor unresponsiveness in living-donor kidney transplantation by MIC therapy. A phase I clinical trial is now under way to test the safety and efficacy of this cell therapeutic approach.


Cell therapeutic approaches to immunosuppression after kidney transplantation may revolutionize clinical transplantation in the future.


Transplantation Immunosuppression Tolerance Regulatory T cells Myeloid suppressor cells Mitomycin C-induced cells 



The TOL-1 study is funded by a grant from the German government (EXIST-Forschungstransfer: TolerogenixX, 03EFB BW56).

Conflicts of Interest


Ethical approval

All procedures will perform in the planned TOL-1 study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent will obtain from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Christian Morath
    • 1
    Email author
  • Anita Schmitt
    • 2
  • Martin Zeier
    • 1
  • Michael Schmitt
    • 2
  • Flavius Sandra-Petrescu
    • 3
  • Gerhard Opelz
    • 3
  • Peter Terness
    • 3
  • Matthias Schaier
    • 1
  • Christian Kleist
    • 3
    Email author
  1. 1.Division of NephrologyUniversity of HeidelbergHeidelbergGermany
  2. 2.GMP Core FacilityUniversity of HeidelbergHeidelbergGermany
  3. 3.Department of Transplantation ImmunologyUniversity of HeidelbergHeidelbergGermany

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