BONE-MARROW AUGMENTATION OF DONOR-CELL CHIMERISM IN KIDNEY, LIVER, HEART, AND PANCREAS ISLET TRANSPLANTATION

We have previously postulated that donor cell chimerism in organ trans plantation is needed to attain a tolerant state. Here we show that don or cell chimerism can be augmented in organ recipients if they are inf used perioperatively with 3 x 10(8) per kg of unmodified donor bone ma rrow cells and are kept on a conventional immunosuppressive regimen of tacrolimus (FK506) and prednisolone. 36 patients took part, of whom t he first 18 patients have good transplanted kidney (n=10), liver (n=7) , and heart (n=7) function when followed up between 4 and 16 months. A ll patients are well. We found persistent multilineage leucocyte chime rism in blood of 17 recipients by flow cytometry and PCR techniques to detect donor alleles or Y chromosomes in female recipients of male or gans. The use of the 5-antigen HLA matched same sex donor precluded de tection of chimerism in one patient.