Important insights on the mechanisms that allow an individual's immune system to accept, rather than reject a donor kidney have emerged from a new study. The recent findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), point to markers that could be monitored to assess and track the health of organs following transplantation.
Immunosuppressive therapy is effective at inhibiting acute rejection. However significant morbidities are associated with the life-long use of immunosuppression.
A team led by Lorenzo Gallon, MD (Northwestern University) and Valeria Mas, PhD (University of Virginia) studied patients in whom tolerance was induced by creating at state of persistent donor chimerism. "Chimerism" is a state in which bone marrow stem cells from two genetically different individuals coexist. The infusion of donor bone marrow cells in organ transplant recipients can lead to chimerism, which subsequently leads to tolerance for any other tissue or organ from the same donor.
"We have shown for the first time molecular pathways occurring in the transplanted organs of chimeric tolerant patients," said Dr. Gallon. "The data generated from this study can help not only longitudinally monitoring our tolerant patients but also could help identify those patients on chronic immunosuppression (the vast majority of the kidney transplant recipients) whose kidneys might have increased expression, due to very low levels of chimerism, of the genes we identified and could therefore be potentially considered for minimization of their immunosuppression."