International Urology and Nephrology

, Volume 43, Issue 1, pp 225–232 | Cite as

Effect of co-transplantation of mesenchymal stem cells and hematopoietic stem cells as compared to hematopoietic stem cell transplantation alone in renal transplantation to achieve donor hypo-responsiveness

  • Aruna V. Vanikar
  • Hargovind L. Trivedi
  • A. Feroze
  • Kamal V. Kanodia
  • Shruti D. Dave
  • Pankaj R. Shah
Nephrology - Original Paper



We evaluated donor hypo-responsiveness in renal allograft recipients to donor adipose tissue-derived mesenchymal stem cell (h-AD-MSC) +hematopoietic stem cell transplantation (HSCT) vs. HSCT alone.


Patients were divided into 2 demographically equal groups (n = 100) A and B subjected to equal non-myeloablative conditioning of target-specific irradiation, anti-T + B cell antibodies and cyclophosphamide with HSCT. Group A was administered h-AD-MSC additionally. Transplantation was performed following favorable cross-matching. Cyclosporine, 3 mg/kg BW/day + prednisone, 20 mg/day were immunosuppressants for first 3 months, cyclosporine was replaced by azathioprine subsequently and prednisone lowered to 5–10 mg/day. Peripheral blood chimerism (PBC) was studied using fluorescent in situ hybridization technique at 3/18 months post transplant. Biopsy was performed for graft dysfunction and reported as per Banff criteria,’05.


Mean nucleated HSC counts (n × 108/kgBW) was 7.32 with mean CD34+ yield 0.09% in group A; and 6.98 and 0.40% in group B, respectively; CD45−/90+ was 13.49% in former. Over 18 months post transplant, former had mean serum creatinine (SCr), 1.59 mg%, 12% acute rejection (AR) episodes, 3% patient, 1% patient +graft loss; latter had mean SCr 1.49 mg%, 18% AR episodes, 1% patient, 6% graft and 8% patient +graft losses. PBC was higher (4%) in former than later (1.8%).


Combined h-AD-MSC +HSCT under non-myeloablative conditioning was safe, more effective than HSCT alone to achieve donor hypo-responsiveness with adequate stable graft function and reduced rejection episodes.


Adipose tissue-derived mesenchymal stem cell Hematopoietic stem cell transplantation Renal transplantation Donor hypo-responsiveness 



Bone marrow


Bone marrow transplantation


Fluorescein isothiocynate


Granulocyte colony stimulating factor


Granulocyte-macrophage colony stimulating factor


Graft versus host disease


Human adipose tissue


Human leukocyte antigen


Hematopoietic stem cell


Hematopoietic stem cell transplantation


Mesenchymal stem cells




Peripheral blood stem cell


Stem cell


Serum creatinine


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Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Aruna V. Vanikar
    • 1
  • Hargovind L. Trivedi
    • 1
  • A. Feroze
    • 1
  • Kamal V. Kanodia
    • 1
  • Shruti D. Dave
    • 1
  • Pankaj R. Shah
    • 1
  1. 1.Institute of Kidney Diseases & Research Centre and Institute of Transplantation SciencesAhmedabadIndia

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