COMBINED KIDNEY BONE-MARROW TRANSPLANTATION

Within the past far, years, a nerv conceptual view of transplantation has emerged based on the observation that renal transplant recipients with extremely long (27-29 years) graft survival all have had evidence of donor cells in their peripheral blood, shin, and lymph nodes.(1) T hey were thus chimeric. This led to the theory that chimerism is neces sary for successful long-term engraftment.(2-4) It also led to the nex t logical step of attempting to augment chimerism by transplanting don or bone marrow at the time of organ transplantation. Early reports of combined organ/bone marrow transplantation have suggested that it is s afe and is associated with reasonable outcomes.(5-8) In this paper, we discuss the outcome in the first 30 patients undergoing combined kidn ey/bone marrow transplantation.