Effect of Living Unrelated Donor Bone Marrow Cell

Infusion on Kidney Allograft Function

Gholamreza Pourmand(1),Behrouz Nikbin(2),Abdolrasoul Mehrsai(1),Mohsen Taherimahmodi(1),Amir Asadpour(1),Ghasem Solgi(2),Sepehr Salem(1),Hannaneh

Wahhabaghai(1) .

1-Urology Research Center ,Sina Hospital , Medical Sciences/University of Tehran, Tehran, Iran.2-Immunogenetic Research Center, Faculty of Medicine, Medical Sciences/University of Tehran, Tehran, Iran.

Objective

• To evaluate the effect of living unrelated donor bone marrow cell infusion on kidney allograft function.

Introduction

• Donor bone marrow infusion (DBMI) has been used in kidney transplantation with the idea of inducing specific immunological unresponsiveness and augmenting the survival of solid organ transplantation.

Materials & Methods

-Nov 2006 to Jul 2007-40 patients:*20 Cases received(150-200cc) concurrent infusion of living unrelated donor bone marrow

*20 controls received transplant alone

Follow up:7 months prospectively

Materials & Methodscontinued

• immunosuppressive regimen: Cyclosporine A, cellcept, and prednisolone

• Follow up evaluation : Serum creatinine level(2 weeks daily then monthly)Necessity of using ATGDelayed graft function (DGF) acute rejection Episodes

Results

Mean serum creatinine(mg/dl)

First 2 weeks 3 weeks to 7 month

DBMI 2.62 1.18

Control 2.34 1.16

Results

Acute Rejection

DGF ATG

DBMI 8(40%) 7(35%) 5(25%)

Control 5(25%) 5(25%) 4(20%)

Results

• Clinical presentations of acute rejection such as fever ,graft tenderness and etc were more severe in control group;however, it was not statistically significant.

• Big lymphocelles required intervention in 3 patients of DBMI group(p≤0.01)and resolved with minimal intervention.

Conclusions

• Infusion of DBM cells was perfectly tolerated.• Decreasing of creatinine level in DBMI groups

was slower than control group; however, clinical presentations seemed more severe in control group.

• Further well-designed studies with large sample size and long-term follow up are warranted.