International Urology and Nephrology

, Volume 43, Issue 1, pp 225–232

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

Abstract

Introduction

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.

Methods

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.

Results

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%).

Conclusion

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.

Keywords

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

Abbreviations

BM

Bone marrow

BMT

Bone marrow transplantation

FITC

Fluorescein isothiocynate

G-CSF

Granulocyte colony stimulating factor

GM-CSF

Granulocyte-macrophage colony stimulating factor

GVHD

Graft versus host disease

h-AD

Human adipose tissue

HLA

Human leukocyte antigen

HSC

Hematopoietic stem cell

HSCT

Hematopoietic stem cell transplantation

MSC

Mesenchymal stem cells

PE

Phycoerythrin

PBSC

Peripheral blood stem cell

SC

Stem cell

SCr

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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