Original Article
Brief Report
Tolerance and Chimerism after Renal and Hematopoietic-Cell Transplantation
N Engl J Med 2008; 358:362-368January 24, 2008
- Abstract
We describe a recipient of combined kidney and hematopoietic-cell transplants from an HLA-matched donor. A post-transplantation conditioning regimen of total lymphoid irradiation and antithymocyte globulin allowed engraftment of the donor's hematopoietic cells. The patient had persistent mixed chimerism, and the function of the kidney allograft has been normal for more than 28 months since discontinuation of all immunosuppressive drugs. Adverse events requiring hospitalization were limited to a 2-day episode of fever with neutropenia. The patient has had neither rejection episodes nor clinical manifestations of graft-versus-host disease.
Media in This Article
Figure 1
Percentages of Donor-Type Cells in Blood, Serum Creatinine Levels, and Cell Counts after Combined Kidney and Hematopoietic-Cell Transplantation.Figure 2
CD4+ and CD8+ T-Cell Subgroups after Transplantation.Article Activity
- Article
Immune tolerance of organ transplants has been induced in laboratory animals when persistent mixed blood and immune-cell chimerism has been achieved by infusing hematopoietic cells from the organ donor before or after transplantation of the organ.1-3 The continued presence of the organ donor's immune cells in the recipient's thymus and peripheral lymphoid tissue promotes and maintains immune tolerance by eliminating T-cell clones that can react to alloantigens of the graft.1-3
We have attempted to achieve persistent mixed chimerism and tolerance in humans after transplantation of combined HLA-matched kidney and hematopoietic cells, using a low-intensity conditioning regimen of total lymphoid irradiation and antithymocyte globulin. This regimen can induce tolerance of organ allografts in laboratory animals.4-6 It also provides protection against graft-versus-host disease when used in patients with hematologic malignant conditions who are given HLA-matched hematopoietic-cell transplants.7 Total lymphoid irradiation can facilitate tolerance of kidney transplants in some patients without the administration of donor hematopoietic cells.8
We enrolled six patients in a study in which the conditioning regimen was given for 10 days after kidney transplantation, and cryopreserved donor cells were infused thereafter. The first patient is described here.
Case Report
The patient was a 47-year-old white man with end-stage renal disease of unknown origin at the time of preemptive kidney transplantation. The kidney donor was his 49-year-old brother, who shared the HLA-type A1,26;B38,51;BW4;DRB1*04,12 with the patient. On the day of kidney transplantation (day 0), the patient received the first of five daily injections of rabbit antithymocyte globulin (1.5 mg per kilogram of body weight), and on day 1 he received the first of 10 doses of 80 cGy each of total lymphoid irradiation. Treatment with cyclosporine was initiated on day 0, with a target whole-blood trough level of 350 to 400 ng per milliliter. Prednisone was administered as premedication for antithymocyte globulin injections and was discontinued on day 10. The patient was discharged from the hospital on day 6, and he completed total lymphoid irradiation in the outpatient clinic on day 14. An intravenous infusion of cryopreserved donor cells was administered in the clinic immediately thereafter. Donor mononuclear cells had been mobilized into the peripheral blood by the administration of granulocyte colony-stimulating factor. They were highly enriched for CD34+ hematopoietic progenitor cells with the use of an immunomagnetic-bead column. A dose of 1×106 CD3+ T cells from the column effluent was injected with 8×106 enriched CD34+ progenitor cells per kilogram.
Mycophenolate mofetil (1000 mg twice a day) was administered for 1 month after the intravenous injection of donor cells. The patient was hospitalized on day 21 because of fever with neutropenia, and was discharged on day 23. Blood cultures were negative, but the fever rapidly resolved after antibiotics were administered. The patient had no further hospitalizations. Two kidney-biopsy specimens were obtained according to an outpatient protocol at 3 and 12 months. Cyclosporine was gradually tapered and was discontinued 6 months after the transplantation. During those 6 months, there were neither rejection episodes nor clinical manifestations of acute or chronic graft-versus-host disease, and the chimerism was persistent. The patient returned to work about 3 months after the transplantation, and graft biopsy specimens showed normal kidney tissue; no cellular infiltrates were seen. Antihypertensive medications were withdrawn shortly after the discontinuation of cyclosporine. The patient remains in good health 34 months after transplantation.
Methods
Conditioning
Total lymphoid irradiation (irradiation of the supradiaphragmatic lymph nodes and thymus and the subdiaphragmatic lymph nodes and spleen) was performed as described previously.9 Rabbit antithymocyte globulin (Thymoglobulin, Genzyme) was given intravenously, starting with an intraoperative injection. The patient received prophylactic medications against fungal, bacterial, and viral infections. The protocol was approved by the institutional review board at Stanford University School of Medicine, and all the patients and donors provided written informed consent.
Donor Cells
Six weeks before transplantation, the donor received a 5-day course of subcutaneous injections of granulocyte colony-stimulating factor at a dose of 16 mg per kilogram per day, and mononuclear cells were harvested by means of leukopheresis. CD34+ cells were enriched with the use of an Isolex column (Baxter) and cryopreserved until they were infused.
Assessment of Chimerism
Chimerism was determined by means of DNA genotyping of simple sequence-length polymorphic markers that encode short tandem repeats, as described previously.10 Chimerism was assessed by analysis of T cells, B cells, natural killer cells, and granulocytes after enrichment of blood mononuclear cells on immunomagnetic beads (Dynabeads, Dynal) coated with monoclonal antibodies against CD3, CD19, CD56, and CD15, respectively.
Immunofluorescence Staining and Analysis of T-Cell Subgroups
Blood mononuclear cells were stained with fluorochrome-conjugated monoclonal antibodies against CD3, CD4, CD8, CD62L, CD45RA, CD45RO (BD Pharmingen), and Vα24,Vβ11 (Beckman Coulter).11 Four-color analyses were performed by means of flow cytometry with the use of standard techniques and equipment (LSR and FACS Vantage cytometers, BD Biosciences).
T-Cell–Receptor Excision Circle Analysis
Sorted subgroups of T cells obtained by means of flow cytometry were cryopreserved and sent to the Human Vaccine Institute Immune Reconstitution Core Facility at Duke University for T-cell–receptor excision-circle (TREC) analysis with the use of a polymerase-chain-reaction–based assay.12
T-Cell Responses to Antigens
The mixed leukocyte reaction was performed by culturing peripheral-blood mononuclear cells as responder cells with irradiated allogeneic mononuclear cells or purified dendritic cells as stimulator cells and measuring 3H-thymidine incorporation.13,14 Dendritic cells were purified with the use of metrizamide gradients.15 Stimulation of mononuclear cells with tetanus toxoid and influenza virus antigens has been described previously.13,14 Concentrations of interleukin-2 and interferon-γ in culture supernatants were measured with the use of commercial kits (BD Pharmingen).
Results
Figure 1AFigure 1
Percentages of Donor-Type Cells in Blood, Serum Creatinine Levels, and Cell Counts after Combined Kidney and Hematopoietic-Cell Transplantation. shows that mixed chimerism developed during the first month after transplantation and persisted until the last analysis, according to testing of short tandem repeats of DNA from purified white-cell subgroups. B cells and natural killer cells in blood contained the highest percentages of donor cells (70 to 85%). Granulocytes ranged between 30 and 70%. The lowest levels of chimerism were detected among T cells, and these levels remained in the range of 5 to 20% for more than 2 years after the transplantation. The level of serum creatinine decreased from about 6 mg per deciliter (530 μmol per liter) before transplantation to a stable level that has been below 2 mg per deciliter (177 μmol per liter) for more than 2 years after the transplantation (Figure 1B). Immunosuppressive drugs were discontinued 6 months after the transplantation.There was transient neutropenia and prolonged lymphopenia (Figure 1C). The absolute number of CD8+ T cells approached pretransplantation levels within 3 months after transplantation and remained above 300 cells per cubic millimeter thereafter (Figure 2AFigure 2
CD4+ and CD8+ T-Cell Subgroups after Transplantation.). The absolute number of CD4+ T cells remained considerably reduced during the first year, however (Figure 2A). The percentages of naive, central memory, effector memory, and effector T cells were also monitored (Figure 2B).16,17 The percentage of naive CD4+ T cells decreased from 40% before conditioning to 10 to 20% for at least 2 years after conditioning (Figure 2C). A rapid decrease in the percentage of naive CD8+ T cells after conditioning was followed by a rapid increase, and 3 months after transplantation, the naive CD8+ T-cell population had exceeded pretransplantation levels (Figure 2D).Recent emigrants from the thymus to the peripheral blood contain DNA fragments of TRECs.11 Figure 2E shows that in healthy subjects, the number of TRECs in purified naive CD4+ and CD8+ T cells is about 10,000 to 20,000 per 100,000 cells, and that the number in effector memory T cells is less than 200 per 100,000 cells. Nineteen months after transplantation, both naive and effector memory CD8+ T cells from the patient contained less than 200 TRECs per 100,000 cells. This result indicates that, instead of emigrating from the thymus, the naive CD8+ T cells had undergone homeostatic expansion.11
The culture of mononuclear cells obtained from the patient before the transplantation and 24 months after the transplantation with irradiated allogeneic mononuclear cells from two healthy subjects resulted in vigorous cellular proliferation as measured by means of 3H-thymidine incorporation (approximately 12,000 to 42,000 cpm) stimulated by cells from both healthy subjects (Figure 3AFigure 3
In Vitro Responses of the Patient's Mononuclear Cells to Stimulation by Alloantigens or Microbial Antigens, before Transplantation and 24 Months after Transplantation.). Background incorporation without stimulator cells was less than 1000 cpm. A comparison of pretransplantation and post-transplantation responses of the recipient's T cells to dendritic cells from the donor showed that there was a significant reduction in the post-transplantation response after subtraction of background counts per minute (P=0.04, by Student's t-test) (Figure 3B). Figure 3C through 3F show that the patient's post-transplantation mononuclear cells were capable of responses to graded concentrations of influenza and tetanus toxoid antigens, as assessed by the secretion of the cytokines interferon-γ and interleukin-2, respectively, into the culture supernatants. The pattern of responses to alloantigens, influenza, and tetanus antigens was similar 18 months after transplantation (data not shown).Discussion
In our patient, the persistence of mixed chimerism after combined kidney and hematopoietic-cell transplantation, the withdrawal of all immunosuppressive therapy, and the uninterrupted normal functioning of the kidney graft are all consistent with the phenomenon of induced immune tolerance in laboratory animals.5,6 We used the same conditioning regimen of total lymphoid irradiation and antithymocyte globulin that has been used in patients with hematolymphoid malignant conditions who received hematopoietic grafts,7 but we reduced the number of donor CD3+ T cells administered from about 200×106 to 300×106 cells per kilogram to 1×106 cells per kilogram in order to reduce the risk of graft-versus-host disease and increase the likelihood of achieving persistent mixed rather than complete chimerism.
The conditioning regimen was not associated with notable adverse events. The patient was discharged from the hospital 6 days after transplantation, and the donor-cell infusion was given in the outpatient clinic. Evidence of adequate immune reconstitution was the absence of opportunistic infections, normal in vitro T-cell responses to tetanus toxoid and influenza antigen, and a vigorous mixed leukocyte reaction to third-party stimulator cells. By contrast, there was a weak response of post-transplantation T cells from the recipient to dendritic cells from the donor.
We examined changes in T-cell subgroups after transplantation to elucidate the source, extent, and kinetics of naive and memory T-cell reconstitution after the initial severe lymphopenia. TREC analysis showed that naive CD8+ T cells returned more rapidly than naive CD4+ T cells, probably because of expansion in the periphery in response to T-cell depletion rather than generation of new cells in the thymus.
The second patient enrolled in the study had a biopsy-confirmed relapse of focal segmental glomerulosclerosis, and severe proteinuria developed during the first week after transplantation. Treatment included a prolonged course of plasmapheresis, antithymocyte globulin, and rituximab. Chimerism was not detected. The patient is receiving cyclosporine and mycophenolate mofetil, and there have been no rejection episodes in 26 months; the current serum creatinine level is 1.2 mg per deciliter (106.1 μmol per liter).
Transient chimerism developed in the third patient, with donor-type cells accounting for a peak of 35 to 65% of natural killer cells, granulocytes, and B cells but only 2% of T cells. The chimeric state was gradually lost in all lineages by the fifth month. A mild rejection episode that developed while the cyclosporine dose was being tapered was reversed by a brief course of corticosteroids, and the current serum creatinine level is 1.1 mg per deciliter (97.2 μmol per liter) 20 months after transplantation while the patient is receiving cyclosporine therapy alone.
The fourth, fifth, and sixth patients were enrolled in the past 6 months, after the protocol was changed to deliver 10 doses of 120 cGy each, instead of 80 cGy each, of total lymphoid irradiation to enhance chimerism. Levels of early peak chimerism were as high as the level in the first patient, with donor-type cells accounting for 39 to 86% of T cells and 31 to 93% of natural killer cells, B cells, and granulocytes.
In a series of seven patients with multiple myeloma given HLA-matched combined kidney and bone marrow transplants, five had transient rather than persistent chimerism, yet all immunosuppressive drugs were discontinued in the five patients.18 These drugs could not be discontinued in two patients, both of whom had persistent complete chimerism, because of the development of graft-versus-host disease.18 Our study shows that it is feasible to achieve persistent mixed chimerism and organ-transplantation tolerance in humans, without the development of graft-versus-host disease.
Supported by a grant (1PO1HL-075462) from the National Heart, Lung, and Blood Institute.
Dr. Scandling reports receiving lecture fees from Astellas and research support from Astellas, Novartis, and Roche; and Dr. Busque, research support from Astellas, Isotechnika, Pfizer, and Novartis. No other potential conflict of interest relevant to this article was reported.
We thank Anne DeLuca for coordination of laboratory and clinic studies; Aditi Mukhopadhyay for technical assistance; Paula Colmenero, Ph.D., for help with performance of in vitro functional studies; and Mary Hansen for preparation of an earlier version of the manuscript.
Source Information
From the Departments of Medicine (J.D.S., S.D.-J., J.A.S., R.L., S.S.), Surgery (S.B., M.T.M.), Pathology (C.B., E.G.E.), and Radiation Oncology (R.T.H.), Stanford University School of Medicine, Stanford, CA.
Address reprint requests to Dr. Strober at the Department of Medicine, Stanford University School of Medicine, Center for Clinical Science Research Bldg., Suite 2215, 269 W. Campus Dr., Stanford, CA 94305, or at sstrober@stanford.edu.
- References
References
1
Sykes M ,Sachs DH . Mixed chimerism. Philos Trans R Soc Lond B Biol Sci 2001;356:707-726
CrossRef | Web of Science | Medline2
Field EH ,Strober S . Tolerance, mixed chimerism and protection against graft-versus-host disease after total lymphoid irradiation. Philos Trans R Soc Lond B Biol Sci 2001;356:739-748
CrossRef | Web of Science | Medline3
Sykes M . Mixed chimerism and transplant tolerance. Immunity 2001;14:417-424
CrossRef | Web of Science | Medline4
Strober S ,Modry DL ,Hoppe RT , et al. Induction of specific unresponsiveness to heart allografts in mongrel dogs treated with total lymphoid irradiation and antithymocyte globulin. J Immunol 1984;132:1013-1018
Web of Science | Medline5
Hayamizu K ,Lan F ,Huie P ,Sibley RK ,Strober S . Comparison of chimeric and non-chimeric tolerance using posttransplant total lymphoid irradiation: cytokine expression and chronic rejection. Transplantation 1999;68:1036-1044
CrossRef | Web of Science | Medline6
Higuchi M ,Zeng D ,Shizuru J , et al. Immune tolerance of combined organ and bone marrow transplants after fractionated lymphoid irradiation involves regulatory NK T cells and clonal deletion. J Immunol 2002;169:5564-5570
Web of Science | Medline7
Lowsky R ,Takahashi T ,Liu YP , et al. Protective conditioning for acute graft-versus-host disease. N Engl J Med 2005;353:1321-1331[Erratum, N Engl J Med 2006;354:884.]
Full Text | Web of Science | Medline8
Strober S ,Dhillon M ,Schubert M , et al. Acquired immune tolerance of cadaveric renal allografts: a study of three patients treated with total lymphoid irradiation. N Engl J Med 1989;321:28-33
Full Text | Web of Science | Medline9
Kaplan HS ,Rosenberg SA . Extended-field radical radiotherapy in advanced Hodgkin's disease: short-term results of 2 randomized clinical trials. Cancer Res 1966;26:1268-1276
Web of Science | Medline10
Millan MT ,Shizuru JA ,Hoffmann P , et al. Mixed chimerism and immunosuppressive drug withdrawal after HLA-mismatched kidney and hematopoietic progenitor transplantation. Transplantation 2002;73:1386-1391
CrossRef | Web of Science | Medline11
Takahashi T ,Dejbakhsh-Jones S ,Strober S . Expression of CD161 (NKR-P1A) defines subsets of human CD4 and CD8 T cells with different functional activities. J Immunol 2006;176:211-216
Web of Science | Medline12
Sempowski G ,Thomasch J ,Gooding M , et al. Effect of thymectomy on human peripheral blood T cell pools in myasthenia gravis. J Immunol 2001;166:2808-2817
Web of Science | Medline13
Engleman EG ,Benike CJ ,Metzler C ,Gatenby PA ,Evans RL . Blocking of human T lymphocyte functions by anti-Leu-2 and anti-Leu-3 antibodies: differential inhibition of proliferation and suppression. J Immunol 1983;130:2623-2628
Web of Science | Medline14
Kansas GS ,Wood GS ,Fishwild DM ,Engleman EG . Functional characterization of human T lymphocyte subsets distinguished by monoclonal anti-leu-8. J Immunol 1985;134:2995-3002
Web of Science | Medline15
Mehta-Damani A ,Markowicz S ,Engleman EG . Generation of antigen-specific CD8+ CTLs from naive precursors. J Immunol 1994;153:996-1003
Web of Science | Medline16
Sallusto F ,Lenig D ,Forster R ,Lipp M ,Lanzavecchia A . Two subsets of memory T lymphocytes with distinct homing potentials and effector functions. Nature 1999;401:708-712
CrossRef | Web of Science | Medline17
Seder RA ,Ahmed R . Similarities and differences in CD4+ and CD8+ effector and memory T cell generation. Nat Immunol 2003;4:835-842
CrossRef | Web of Science | Medline18
Fudaba Y ,Spitzer TR ,Shaffer J , et al. Myeloma responses and tolerance following combined kidney and nonmyeloablative marrow transplantation: in vivo and in vitro analyses. Am J Transplant 2006;6:2121-2133
CrossRef | Web of Science | Medline
- Citing Articles (127)
Citing Articles
1
Moslem Ranjbar, Ghasem Solgi, Mousa Mohammadnia, Behrouz Nikbin, Gholamreza Pourmand, Bita Ansaripour, Aliakbar Amirzargar. (2012) Regulatory T-cell subset analysis and profile of interleukin (IL)-10, IL-17 and interferon-gamma cytokine-producing cells in kidney allograft recipients with donor cells infusion. Clinical and Experimental Nephrology
CrossRef2
Nina Pilat, Karin Hock, Thomas Wekerle. (2012) Mixed chimerism through donor bone marrow transplantation. Current Opinion in Organ Transplantation 17:1, 63-70
CrossRef3
Jos Domen, Kimberly Gandy, Jignesh Dalal. (2012) Emerging uses for pediatric hematopoietic stem cells. Pediatric Research
CrossRef4
Paul Szabolcs, William J. Burlingham, Angus W. Thomson. (2012) Tolerance after Solid Organ and Hematopoietic Cell Transplantation. Biology of Blood and Marrow Transplantation 18:1, S193-S200
CrossRef5
Manei Oku, Masayoshi Okumi, Akira Shimizu, Hisashi Sahara, Kentaro Setoyama, Hiroaki Nishimura, Masaharu Sada, Joseph Scalea, Akio Ido, David H. Sachs, Hirohito Tsubouchi, Kazuhiko Yamada. (2012) Hepatocyte Growth Factor Sustains T Regulatory Cells and Prolongs the Survival of Kidney Allografts in Major Histocompatibility Complex-Inbred CLAWN-Miniature Swine. Transplantation 93:2, 148-155
CrossRef6
H.L. Trivedi, A.V. Vanikar, M.R. Gumber, H.V. Patel, P.R. Shah, V.B. Kute. (2012) Abrogation of Antibodies Improves Outcome of Renal Transplantation. Transplantation Proceedings 44:1, 241-247
CrossRef7
Q. Tang, J. A. Bluestone, S.-M. Kang. (2011) CD4+Foxp3+ regulatory T cell therapy in transplantation. Journal of Molecular Cell Biology
CrossRef8
Lars P Kihm, Martin Zeier, Christian Morath. (2011) Emerging drugs for the treatment of transplant rejection. Expert Opinion on Emerging Drugs 16:4, 683-695
CrossRef9
Hong Jiang, Haiyan Tu, Zhimin Chen, Rongjun Chen, Yucheng Wang, Minmin Wang, Juan Jin, Shi Feng, Wenqing Chen, Yan Bi, Huiping Wang, Youying Mao, Zhangfei Shou, Jianghua Chen. (2011) Effects of chimerism on the mice heart transplanted survival with the bone marrow infusion. Transplant Immunology 25:4, 202-206
CrossRef10
Valeria Crudele, Antonietta Picascia, Teresa Infante, Vincenzo Grimaldi, Ciro Maiello, Claudio Napoli. (2011) Repeated immune and non immune insults to the graft after heart transplantation. Immunology Letters 141:1, 18-27
CrossRef11
Éric Thervet, Julien Zuber, Rebecca Sberro, Guillaume Canaud, Dany Anglicheau, Renaud Snanoudj, Marie-France Mamzer-Bruneel, Franck Martinez, Christophe Legendre. (2011) Traitements immunosuppresseurs : mécanismes d’action et utilisation clinique. Néphrologie & Thérapeutique 7:7, 566-581
CrossRef12
T. Hautz, G. Brandacher, T.O. Engelhardt, G. Pierer, W.P.A. Lee, J. Pratschke, S. Schneeberger. (2011) How Reconstructive Transplantation Is Different From Organ Transplantation—and How It Is Not. Transplantation Proceedings 43:9, 3504-3511
CrossRef13
K.V. Ravindra, H. Xu, S.T. Ildstad. (2011) Vascularized Composite Allotransplantation at a Crossroad. Transplantation Proceedings 43:9, 3501-3503
CrossRef14
Vijay S. Gorantla, Gerald Brandacher, Stefan Schneeberger, Xin Xiao Zheng, Albert D. Donnenberg, Joseph E. Losee, W.P. Andrew Lee. (2011) Favoring the Risk–Benefit Balance for Upper Extremity Transplantation—The Pittsburgh Protocol. Hand Clinics 27:4, 511-520
CrossRef15
Kadiyala V. Ravindra, Suzanne T. Ildstad. (2011) Immunosuppressive Protocols and Immunological Challenges Related to Hand Transplantation. Hand Clinics 27:4, 467-479
CrossRef16
Michele Curcio, Diego Cantarovich, Serena Barbuti, Ugo Boggi, Silvia Chelazzi, Daniele Focosi, Simone Lapi, Gabriella Paleologo, Gaetano Rizzo, Fabrizio Scatena, Fabio Vistoli, Orazio Vittorio, Silvano Presciuttini, Franco Mosca. (2011) Association of donor-specific microchimerism with graft dysfunction in kidney transplant patients. Transplant Immunology
CrossRef17
Scandling, John D., Busque, Stephan, Shizuru, Judith A., Engleman, Edgar G., Strober, Samuel, . (2011) Induced Immune Tolerance for Kidney Transplantation. New England Journal of Medicine 365:14, 1359-1360
Full Text18
T. Okabayashi, A. M. Cameron, M. Hisada, R. A. Montgomery, G. M. Williams, Z. Sun. (2011) Mobilization of Host Stem Cells Enables Long-Term Liver Transplant Acceptance in a Strongly Rejecting Rat Strain Combination. American Journal of Transplantation 11:10, 2046-2056
CrossRef19
Valeriya Zarkhin, Minnie M. Sarwal. (2011) The coin toss of B cell in rejection and tolerance: Danger versus defense. Seminars in Immunology
CrossRef20
J. J. Lozano, A. Pallier, M. Martinez-Llordella, R. Danger, M. López, M. Giral, M. C. Londoño, A. Rimola, J. P. Soulillou, S. Brouard, A. Sánchez-Fueyo. (2011) Comparison of Transcriptional and Blood Cell-Phenotypic Markers Between Operationally Tolerant Liver and Kidney Recipients. American Journal of Transplantation 11:9, 1916-1926
CrossRef21
Eran Ophir, Yaki Eidelstein, Esti Bachar-Lustig, David Hagin, Noga Or-Geva, Assaf Lask, Yair Reisner. (2011) Induction of transplantation tolerance in haploidenical transplantation under reduced intensity conditioning: The role of ex-vivo generated donor CD8+ T cells with central memory phenotype. Best Practice & Research Clinical Haematology 24:3, 393-401
CrossRef22
Nina Pilat, Christoph Klaus, Martina Gattringer, Elmar Jaeckel, Fritz Wrba, Dela Golshayan, Ulrike Baranyi, Thomas Wekerle. (2011) Therapeutic Efficacy of Polyclonal Tregs Does Not Require Rapamycin in a Low-Dose Irradiation Bone Marrow Transplantation Model. Transplantation 92:3, 280-288
CrossRef23
Megan Sykes, Gary Levy. (2011) Advances in transplantation. Seminars in Immunology 23:4, 222-223
CrossRef24
Tatsuo Kawai, A. Benedict Cosimi, David H. Sachs. (2011) Preclinical and clinical studies on the induction of renal allograft tolerance through transient mixed chimerism. Current Opinion in Organ Transplantation 16:4, 366-371
CrossRef25
Nina Pilat, Mohamed H. Sayegh, Thomas Wekerle. (2011) Costimulatory pathways in transplantation. Seminars in Immunology 23:4, 293-303
CrossRef26
Samuel Strober, Thomas R. Spitzer, Robert Lowsky, Megan Sykes. (2011) Translational studies in hematopoietic cell transplantation: Treatment of hematologic malignancies as a stepping stone to tolerance induction. Seminars in Immunology 23:4, 273-281
CrossRef27
R. N. Barth, E. D. Rodriguez, G. S. Mundinger, A. J. Nam, J. S. Ha, H. Hui-Chou, L. S. Jones, A. Panda, S. T. Shipley, C. B. Drachenberg, D. Kukuruga, S. T. Bartlett. (2011) Vascularized Bone Marrow-Based Immunosuppression Inhibits Rejection of Vascularized Composite Allografts in Nonhuman Primates. American Journal of Transplantation 11:7, 1407-1416
CrossRef28
S. Álvarez, A. Boltansky, J. Alfaro, L. Sepúlveda, M. Ursu, G. Innocenti, D. Carvajal, G. Villamizar, M. Hurtado, A. Vukusich. (2011) Unresponsiveness to a Kidney Graft After a Fully Matched Allogenic Bone Marrow Transplantation Combined With Low-Dose Tacrolimus Therapy: A Case Report. Transplantation Proceedings 43:6, 2344-2346
CrossRef29
A M Azimzadeh, J R Lees, Y Ding, J S Bromberg. (2011) Immunobiology of Transplantation: Impact on Targets for Large and Small Molecules. Clinical Pharmacology & Therapeutics 90:2, 229-242
CrossRef30
M. A. Azancot, F. Moreso, C. Cantarell, I. B. Torres, D. R. Seron. (2011) Histological findings in two renal transplants accomplishing operational tolerance criteria. NDT Plus 4:3, 198-200
CrossRef31
G. Andreola, M. Chittenden, J. Shaffer, A. B. Cosimi, T. Kawai, P. Cotter, S. A. LoCascio, T. Morokata, B. R. Dey, N. T. Tolkoff-Rubin, F. Preffer, T. Bonnefoix, K. Kattleman, T. R. Spitzer, D. H. Sachs, M. Sykes. (2011) Mechanisms of Donor-Specific Tolerance in Recipients of Haploidentical Combined Bone Marrow/Kidney Transplantation. American Journal of Transplantation 11:6, 1236-1247
CrossRef32
Pietro E. Cippà, Thomas Fehr. (2011) Spontaneous tolerance in kidney transplantation - an instructive, but very rare paradigm*. Transplant International 24:6, 534-535
CrossRef33
Allison Webber, Ryutaro Hirose, Flavio Vincenti. (2011) Novel Strategies in Immunosuppression: Issues in Perspective. Transplantation 91:10, 1057-1064
CrossRef34
G. Alex Bishop, Francesco L. Ierino, Alexandra F. Sharland, Bruce M. Hall, Stephen I. Alexander, Mauro S. Sandrin, P. Toby Coates, Geoffrey W. McCaughan. (2011) Approaching the Promise of Operational Tolerance in Clinical Transplantation. Transplantation 91:10, 1065-1074
CrossRef35
Jos Domen, Lei Sun, Katie Trapp, Nima Maghami, Elica Inagaki, Yongwu Li, Pippa Simpson, Kimberly L. Gandy. (2011) Tolerance induction by hematopoietic cell transplantation: Combined use of stem cells and progenitor cells. The Journal of Heart and Lung Transplantation 30:5, 507-514
CrossRef36
Fred Fändrich. (2011) Tolerance in clinical transplantation: progress, challenge or just a dream?. Langenbeck's Archives of Surgery 396:4, 475-487
CrossRef37
Ibrahiem Saeed Abdul-Rahman. (2011) Renal Disease in Hematological Malignancies. Hong Kong Journal of Nephrology 13:1, 5-18
CrossRef38
Mohamed Mabed. (2011) The Potential Utility of Bone Marrow or Umbilical Cord Blood Transplantation For the Treatment of Type I Diabetes Mellitus. Biology of Blood and Marrow Transplantation 17:4, 455-464
CrossRef39
Simon D. Tran, Robert S. Redman, A. John Barrett, Steven Z. Pavletic, Sharon Key, Younan Liu, Ashley Carpenter, Hieu M. Nguyen, Yoshinori Sumita, Bruce J. Baum, Stanley R. Pillemer, Eva Mezey. (2011) Microchimerism in Salivary Glands after Blood- and Marrow-Derived Stem Cell Transplantation. Biology of Blood and Marrow Transplantation 17:3, 429-433
CrossRef40
Kenneth A. Newell. (2011) Clinical transplantation tolerance. Seminars in Immunopathology 33:2, 91-104
CrossRef41
José Antonio Pons, Beatriz Revilla-Nuin, Pablo Ramírez, Alberto Baroja-Mazo, Pascual Parrilla. (2011) Desarrollo de inmunotolerancia en el trasplante hepático. Gastroenterología y Hepatología 34:3, 155-169
CrossRef42
Agnieszka Czechowicz, Irving L. Weissman. (2011) Purified Hematopoietic Stem Cell Transplantation: The Next Generation of Blood and Immune Replacement. Hematology/Oncology Clinics of North America 25:1, 75-87
CrossRef43
T. J. Grazia, R. J. Plenter, H. M. Lepper, F. Victorino, S. D. Miyamoto, J. T. Crossno Jr., B. A. Pietra, R. G. Gill, M. R. Zamora. (2011) Prolongation of Cardiac Allograft Survival by a Novel Population of Autologous CD117+ Bone Marrow-Derived Progenitor Cells. American Journal of Transplantation 11:1, 34-44
CrossRef44
Outi E Päiväniemi, Petra Musilova, Peter M Raivio, Paula K Maasilta, Hanni S Alho, Jiri Rubes, Kristiina Aittomäki, Ulla-Stina Salminen. (2011) Ingraft chimerism in lung transplantation - a study in a porcine model of obliterative bronchiolitis. Respiratory Research 12:1, 56
CrossRef45
J. Fangmann, H. Kathrin Al-Ali, U. Sack, M. Kamprad, H. M. Tautenhahn, S Faber, J. Hauss, D. Niederwieser, T. Lindner, A. Bachmann. (2011) Kidney Transplant from the Same Donor without Maintenance Immunosuppression after Previous Hematopoietic Stem Cell Transplant. American Journal of Transplantation 11:1, 156-162
CrossRef46
Alberto Sánchez–Fueyo, Terry B. Strom. (2011) Immunologic Basis of Graft Rejection and Tolerance Following Transplantation of Liver or Other Solid Organs. Gastroenterology 140:1, 51-64.e2
CrossRef47
Gerhard S. Mundinger, Joseph A. Kelamis, Soon H. Kim, Michael Magarakis, Luke S. Jones, Jinny S. Ha, Eduardo D. Rodriguez. (2011) Tunneled superficial inferior epigastric artery (SIEA) myocutaneous/vascularized femur chimeric flaps: A model to study the role of vascularized bone marrow in composite allografts. Microsurgeryn/a-n/a
CrossRef48
Fred Fändrich. (2010) Cell therapy approaches aiming at minimization of immunosuppression in solid organ transplantation. Current Opinion in Organ Transplantation 15:6, 703-708
CrossRef49
Nina Pilat, Thomas Wekerle. (2010) Mechanistic and therapeutic role of regulatory T cells in tolerance through mixed chimerism. Current Opinion in Organ Transplantation 15:6, 725-730
CrossRef50
Alberto Sánchez-Fueyo. (2010) Identification of tolerant recipients following liver transplantation. International Immunopharmacology 10:12, 1501-1504
CrossRef51
Nazia Selzner, David R. Grant, Itay Shalev, Gary A. Levy. (2010) The immunosuppressive pipeline: Meeting unmet needs in liver transplantation. Liver Transplantation 16:12, 1359-1372
CrossRef52
Giuseppe Orlando, Peiman Hematti, Robert J. Stratta, George W. Burke, Pierpaolo Di Cocco, Francesco Pisani, Shay Soker, Kathryn Wood. (2010) Clinical Operational Tolerance After Renal Transplantation. Annals of Surgery 252:6, 915-928
CrossRef53
C. P. Larsen, A. Page, K. H. Linzie, M. Russell, T. Deane, L. Stempora, E. Strobert, M. C. T. Penedo, T. Ward, R. Wiseman, D. O’Connor, W. Miller, S. Sen, K. Singh, L. S. Kean. (2010) An MHC-Defined Primate Model Reveals Significant Rejection of Bone Marrow After Mixed Chimerism Induction Despite Full MHC Matching. American Journal of Transplantation 10:11, 2396-2409
CrossRef54
Giuseppe Orlando. (2010) Finding the right time for weaning off immunosuppression in solid organ transplant recipients. Expert Review of Clinical Immunology 6:6, 879-892
CrossRef55
Patrick-Nikolaus Nierlich, Christoph Klaus, Sinda Bigenzahn, Nina Pilat, Zvonimir Koporc, Ines Pree, Ulrike Baranyi, Masaru Taniguchi, Ferdinand Muehlbacher, Thomas Wekerle. (2010) The role of natural killer T cells in costimulation blockade-based mixed chimerism. Transplant International 23:11, 1179-1189
CrossRef56
Alberto Sánchez-Fueyo. (2010) Identification of operationally tolerant liver transplant recipients. Liver Transplantation 16:S2, S82-S86
CrossRef57
Nina Pilat, Thomas Wekerle. (2010) Transplantation tolerance through mixed chimerism. Nature Reviews Nephrology 6:10, 594-605
CrossRef58
Maria Pleguezuelo, Giacomo Germani, Andrew K Burroughs. 2010. Liver Transplantation: Prevention and Treatment of Rejection. , 685-723.
CrossRef59
Adam D. Griesemer, Eric C. Sorenson, Mark A. Hardy. (2010) The Role of the Thymus in Tolerance. Transplantation 90:5, 465-474
CrossRef60
Nicolas Poirier, Gilles Blancho, Bernard Vanhove. (2010) Alternatives to calcineurin inhibition in renal transplantation: belatacept, the first co-stimulation blocker. Immunotherapy 2:5, 625-636
CrossRef61
A. M. S. Muller, J. A. Linderman, M. Florek, D. Miklos, J. A. Shizuru. (2010) Allogeneic T cells impair engraftment and hematopoiesis after stem cell transplantation. Proceedings of the National Academy of Sciences 107:33, 14721-14726
CrossRef62
Manuela Battaglia. (2010) Potential T regulatory cell therapy in transplantation: how far have we come and how far can we go?. Transplant International 23:8, 761-770
CrossRef63
Hisashi Bashuda, Akira Shimizu, Masateru Uchiyama, Ko Okumura. (2010) Prolongation of renal allograft survival by anergic cells: advantages and limitations. Clinical Transplantation 24, 6-10
CrossRef64
Tatsuo Kawai, A. Benedict Cosimi. (2010) Induction of tolerance in clinical kidney transplantation. Clinical Transplantation 24, 2-5
CrossRef65
Bernd Schröppel, Peter S. Heeger. (2010) Gazing into a crystal ball to predict kidney transplant outcome. Journal of Clinical Investigation 120:6, 1803-1806
CrossRef66
James M. Mathew, Gaetano Ciancio, George W. Burke, Rolando O. Garcia-Morales, Anne Rosen, Edward Wang, Carmen I. Gomez, Bonnie B. Blomberg, Laphalle Fuller, Violet Esquenazi, Camillo Ricordi, Joshua Miller. (2010) Immune “tolerance profiles” in donor bone marrow infused kidney transplant patients using multiple ex vivo functional assays. Human Immunology 71:6, 566-576
CrossRef67
Agnieszka Czechowicz, Irving L. Weissman. (2010) Purified Hematopoietic Stem Cell Transplantation: The Next Generation of Blood and Immune Replacement. Immunology and Allergy Clinics of North America 30:2, 159-171
CrossRef68
A. Osama Gaber, Anthony P. Monaco, James A. Russell, Yvon Lebranchu, Mohamad Mohty. (2010) Rabbit Antithymocyte Globulin (Thymoglobulin®). Drugs 70:6, 691-732
CrossRef69
Vicki Seyfert-Margolis, Sandy Feng. (2010) Tolerance: Is It Achievable in Pediatric Solid Organ Transplantation?. Pediatric Clinics of North America 57:2, 523-538
CrossRef70
J C Choy. (2010) Granzymes and perforin in solid organ transplant rejection. Cell Death and Differentiation 17:4, 567-576
CrossRef71
E. Ophir, Y. Eidelstein, R. Afik, E. Bachar-Lustig, Y. Reisner. (2010) Induction of tolerance to bone marrow allografts by donor-derived host nonreactive ex vivo-induced central memory CD8 T cells. Blood 115:10, 2095-2104
CrossRef72
J. L. Mollov, C. L. Lucas, F. Haspot, J. Kurtz, C. Gaspar, A. Guzman, M. Sykes. (2010) Recipient Dendritic Cells, But Not B Cells, Are Required Antigen-Presenting Cells for Peripheral Alloreactive CD8 + T-Cell Tolerance. American Journal of Transplantation 10:3, 518-526
CrossRef73
R. G. Nador, D. Hongo, Z. Yao, S. Strober. (2010) The Changed Balance of Regulatory and Naive T Cells Promotes Tolerance after TLI and Anti-T-Cell Antibody Conditioning. American Journal of Transplantation 10:2, 262-272
CrossRef74
Masato Fujiki, Carlos O. Esquivel, Olivia M. Martinez, Samuel Strober, Shinji Uemoto, Sheri M. Krams. (2010) Induced tolerance to rat liver allografts involves the apoptosis of intragraft T cells and the generation of CD4 + CD25 + FoxP3 + T regulatory cells. Liver Transplantation 16:2, 147-154
CrossRef75
Yoshinori Ishikawa, Atsushi Hirakata, Adam D. Griesemer, Justin Etter, Shannon Moran, Joshua Weiner, Akira Shimizu, Kazuhiko Yamada. (2010) Tolerance and Long-Lasting Peripheral Chimerism After Allogeneic Intestinal Transplantation in MGH Miniature Swine. Transplantation 89:4, 417-426
CrossRef76
Sykes, Megan, . (2010) Immune Evasion by Chimeric Trachea. New England Journal of Medicine 362:2, 172-174
Full Text77
Jamil Azzi, Abdallah S Geara, Suzanne El-Sayegh, Reza Abdi. (2010) Immunological aspects of pancreatic islet cell transplantation. Expert Review of Clinical Immunology 6:1, 111-124
CrossRef78
Dinh Quang Truong, Christophe Bourdeaux, Grégoire Wieërs, Pascale Saussoy, Dominique Latinne, Raymond Reding. (2009) The immunological monitoring of kidney and liver transplants in adult and pediatric recipients. Transplant Immunology 22:1-2, 18-27
CrossRef79
Ronald F Parsons, Kumar Vivek, Robert R Redfield, Thi-Sau Migone, Michael P Cancro, Ali Naji, Hooman Noorchashm. (2009) B-cell tolerance in transplantation: is repertoire remodeling the answer?. Expert Review of Clinical Immunology 5:6, 703-723
CrossRef80
Holbrook Kohrt, Robert Lowsky. (2009) Nonmyeloablative conditioning with total lymphoid irradiation and antithymocyte globulin: an update. Current Opinion in Hematology 16:6, 460-465
CrossRef81
Carlos Benítez, Juan José Lozano, Alberto Sánchez Fueyo. (2009) Gene Expression Profiling and Transplantation Tolerance in the Clinic. Transplantation 88:Supplement, S50-S53
CrossRef82
James R. Scott. (2009) In Defense of Case Reports. Obstetrics & Gynecology 114:Supplement, 413-414
CrossRef83
Hmadcha Abdelkrim, Domínguez-Bendala Juan, Wakeman Jane, Arredouani Mohamed, Soria Bernat. (2009) The immune boundaries for stem cell based therapies: problems and prospective solutions. Journal of Cellular and Molecular Medicine 13:8a, 1464-1475
CrossRef84
Debbie Watson, Min Hu, Geoff Y Zhang, Yuan Min Wang, Stephen I Alexander. (2009) Tolerance induction by removal of alloreactive T cells: in-vivo and pruning strategies. Current Opinion in Organ Transplantation 14:4, 357-363
CrossRef85
Josep M. Cruzado, Oriol Bestard, Josep M. Grinyó. (2009) New Immunosuppressive Protocols With the Advent of Novel Biological Drugs. Transplantation 88:Supplement, S20-S23
CrossRef86
H. E. Kohrt, B. B. Turnbull, K. Heydari, J. A. Shizuru, G. G. Laport, D. B. Miklos, L. J. Johnston, S. Arai, W.-K. Weng, R. T. Hoppe, P. W. Lavori, K. G. Blume, R. S. Negrin, S. Strober, R. Lowsky. (2009) TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors. Blood 114:5, 1099-1109
CrossRef87
George D. Comerci, Thomas M. Williams, Susan Kellie. (2009) Immune Tolerance After Total Lymphoid Irradiation for Heart Transplantation: Immunosuppressant-free Survival for 8 Years. The Journal of Heart and Lung Transplantation 28:7, 743-745
CrossRef88
Julie M. Yabu, Flavio Vincenti. (2009) Kidney Transplantation: The Ideal Immunosuppression Regimen. Advances in Chronic Kidney Disease 16:4, 226-233
CrossRef89
K. L. Womer, B. Kaplan. (2009) Recent Developments in Kidney Transplantation-A Critical Assessment. American Journal of Transplantation 9:6, 1265-1271
CrossRef90
Birgit Sawitzki, Andreas Pascher, Nina Babel, Petra Reinke, Hans-Dieter Volk. (2009) Can We Use Biomarkers and Functional Assays to Implement Personalized Therapies in Transplantation?. Transplantation 87:11, 1595-1601
CrossRef91
S. Janes, P. Dhaliwal, K. Wood. (2009) Tolerance in renal transplantation: is mixed chimerism the missing link?. Nephrology Dialysis Transplantation 24:6, 1726-1729
CrossRef92
Eran Ophir, Yair Reisner. (2009) Induction of tolerance in organ recipients by hematopoietic stem cell transplantation. International Immunopharmacology 9:6, 694-700
CrossRef93
Carlos O. Esquivel, Christian Benden. (2009) Clinical models of tolerance induction in pediatric transplantation. Pediatric Transplantation 13:4, 397-399
CrossRef94
Rosa Ayala, Silvia Grande, Enriqueta Albizua, Almudena Crooke, Juan Carlos Meneu, Almudena Moreno, Baltasar Pérez, Florinda Gilsanz, Enrique Moreno, Joaquín Martínez-Lopez. (2009) Long-term follow-up of donor chimerism and tolerance after human liver transplantation. Liver Transplantation 15:6, 581-591
CrossRef95
M. Goldman, K. Wood. (2009) Translating transplantation tolerance in the clinic: where are we, where do we go?. Clinical & Experimental Immunology 156:2, 185-188
CrossRef96
Matthias von Herrath, Andrew Chan. (2009) How can we improve the translational landscape for a faster cure of type 1 diabetes?. Journal of Clinical Investigation 119:5, 1061-1065
CrossRef97
Michel Goldman, Kathryn Wood. (2009) Transplantation Research: Will We Ever Reach the Holy Grail?. Transplantation 87:Supplement, S99-S100
CrossRef98
H. Haller, N. Richter, V. Bröcker, W. Gwinner, F. Gueler, A. Schwarz. (2009) Aktuelle Probleme der Nierentransplantation. Der Internist 50:5, 523-535
CrossRef99
Bruce M. Hall, Giang Tran, Suzanne J. Hodgkinson. (2009) Alloantigen specific T regulatory cells in transplant tolerance. International Immunopharmacology 9:5, 570-574
CrossRef100
A. B. Pillai, T. I. George, S. Dutt, S. Strober. (2009) Host natural killer T cells induce an interleukin-4-dependent expansion of donor CD4+CD25+Foxp3+ T regulatory cells that protects against graft-versus-host disease. Blood 113:18, 4458-4467
CrossRef101
Allan D. Kirk. (2009) Clinical Tolerance 2008. Transplantation 87:7, 953-955
CrossRef102
Zhenyu Yao, Yinping Liu, Jennifer Jones, Samuel Strober. (2009) Differences in Bcl-2 expression by T-cell subsets alter their balance after in vivo irradiation to favor CD4 + Bcl-2 hi NKT cells. European Journal of Immunology 39:3, 763-775
CrossRef103
Jacqueline van de Wetering, Jeroen H. Gerrits, Nicole M. van Besouw, Jan N. M. IJzermans, Willem Weimar. (2009) Successful Tapering of Immunosuppression to Low-Dose Monotherapy Steroids After Living-Related Human Leukocyte Antigen-Identical Renal Transplantation. Transplantation 87:5, 740-744
CrossRef104
Gregor Warnecke, James A. Hutchinson, Paloma Riquelme, Bianca Kruse, Stefanie Thissen, Murat Avsar, Gregor Zehle, Thomas Steinkamp, Carsten Peters, Rolf Baumann, Felix Gövert, Hendrik Ungefroren, Florian Länger, André R. Simon, Johann H. Karstens, Volkhard Kaever, Axel Haverich, Fred Fändrich, Martin Strüber. (2009) Postoperative intravenous infusion of donor-derived transplant acceptance-inducing cells as an adjunct immunosuppressive therapy in a porcine pulmonary allograft model. Transplant International 22:3, 332-341
CrossRef105
Megan Sykes. (2009) Hematopoietic Cell Transplantation for Tolerance Induction: Animal Models to Clinical Trials. Transplantation 87:3, 309-316
CrossRef106
Anthony J. Demetris, John G. Lunz III, Parmjeet Randhawa, Tong Wu, Michael Nalesnik, Angus W. Thomson. (2009) Monitoring of human liver and kidney allograft tolerance: a tissue/histopathology perspective. Transplant International 22:1, 120-141
CrossRef107
Davide Mineo, Junichiro Sageshima, George W. Burke, Camillo Ricordi. (2009) Minimization and withdrawal of steroids in pancreas and islet transplantation. Transplant International 22:1, 20-37
CrossRef108
Kareem M. Abu-Elmagd, Guilherme Costa, Geoffrey J. Bond, Tong Wu, Noriko Murase, Adriana Zeevi, Richard Simmons, Kyle Soltys, Rakesh Sindhi, William Stein, Anthony Demetris, George Mazariegos. (2009) Evolution of the immunosuppressive strategies for the intestinal and multivisceral recipients with special reference to allograft immunity and achievement of partial tolerance. Transplant International 22:1, 96-109
CrossRef109
(2008) The D&T Report. Dialysis & Transplantation 37:12, 476-482
CrossRef110
Thomas Fehr, Megan Sykes. (2008) Clinical experience with mixed chimerism to induce transplantation tolerance. Transplant International 21:12, 1118-1135
CrossRef111
Manei Oku, Masayoshi Okumi, Hisashi Sahara, Atsushi Hirakata, Takashi Onoe, Adam D. Griesemer, Kazuhiko Yamada. (2008) Porcine CFSE mixed lymphocyte reaction and PKH-26 cell-mediated lympholysis assays. Transplant Immunology 20:1-2, 78-82
CrossRef112
Lakshmanan Krishnamurti, Sandhya Kharbanda, Melinda A. Biernacki, Wandi Zhang, K. Scott Baker, John E. Wagner, Catherine J. Wu. (2008) Stable Long-Term Donor Engraftment following Reduced-Intensity Hematopoietic Cell Transplantation for Sickle Cell Disease. Biology of Blood and Marrow Transplantation 14:11, 1270-1278
CrossRef113
Avram Z Traum, Dicken SC Ko, Tatsuo Kawai. (2008) The potential for tolerance in pediatric renal transplantation. Current Opinion in Organ Transplantation 13:5, 489-494
CrossRef114
Kadiyala V. Ravindra, Joseph F. Buell, Christina L. Kaufman, Brenda Blair, Michael Marvin, Ravi Nagubandi, Warren C. Breidenbach. (2008) Hand transplantation in the United States: Experience with 3 patients. Surgery 144:4, 638-644
CrossRef115
X. Luo, K. L. Pothoven, D. McCarthy, M. DeGutes, A. Martin, D. R. Getts, G. Xia, J. He, X. Zhang, D. B. Kaufman, S. D. Miller. (2008) ECDI-fixed allogeneic splenocytes induce donor-specific tolerance for long-term survival of islet transplants via two distinct mechanisms. Proceedings of the National Academy of Sciences 105:38, 14527-14532
CrossRef116
J L Liesveld, P G Rothberg. (2008) Mixed chimerism in SCT: conflict or peaceful coexistence?. Bone Marrow Transplantation 42:5, 297-310
CrossRef117
Valeriya Zarkhin, Minnie M. Sarwal. (2008) Microarrays: Monitoring for Transplant Tolerance and Mechanistic Insights. Clinics in Laboratory Medicine 28:3, 385-410
CrossRef118
Alexandru Schiopu, Kathryn J Wood. (2008) Regulatory T cells: hypes and limitations. Current Opinion in Organ Transplantation 13:4, 333-338
CrossRef119
Jerzy W Kupiec-Weglinski. (2008) Tolerance induction. Current Opinion in Organ Transplantation 13:4, 331-332
CrossRef120
P. F. Halloran, J. Bromberg, B. Kaplan, F. Vincenti. (2008) Tolerance Versus Immunosuppression: A Perspective. American Journal of Transplantation 8:7, 1365-1366
CrossRef121
D. Mineo, C. Ricordi, X. Xu, A. Pileggi, R. Garcia-Morales, A. Khan, D. A. Baidal, D. Han, K. Monroy, J. Miller, A. Pugliese, T. Froud, L. Inverardi, N. S. Kenyon, R. Alejandro. (2008) Combined Islet and Hematopoietic Stem Cell Allotransplantation: A Clinical Pilot Trial to Induce Chimerism and Graft Tolerance. American Journal of Transplantation 8:6, 1262-1274
CrossRef122
(2008) Successful induction of immune tolerance in kidney graft recipients. Nature Clinical Practice Nephrology 4:5, 243-243
CrossRef123
(2008) Journal Club. Kidney International 73:7, 804-805
CrossRef124
Alisa Opar. (2008) As demand for organs expands, so does transplant technology. Nature Medicine 14:3, 225-225
CrossRef125
Starzl, Thomas E., . (2008) Immunosuppressive Therapy and Tolerance of Organ Allografts. New England Journal of Medicine 358:4, 407-411
Full Text126
Heidi Ledford. (2008) Organ transplants without rejection. Nature
CrossRef127
David M. Miller, Thomas B. Thornley, Dale L. Greiner, Aldo A. Rossini. (2008) Viral Infection: A Potent Barrier to Transplantation Tolerance. Clinical and Developmental Immunology 2008, 1-14
CrossRef
