Macrochimerism in Intestinal Transplantation: Association With Lower Rejection Rates and Multivisceral Transplants, Without GVHD. Issue 10 (18th May 2015)

• Record Type: Journal Article
• Authors: Zuber, J.; Rosen, S.; Shonts, B.; Sprangers, B.; Savage, T. M.; Richman, S.; Yang, S.; Lau, S. P.; DeWolf, S.; Farber, D.; Vlad, G.; Zorn, E.; Wong, W.; Emond, J.; Levin, B.; Martinez, M.; Kato, T.; Sykes, M.
• Is Part Of: American journal of transplantation. Volume 15:Issue 10(2015:Oct.)
• Page Start: 2691
• Page End: 2703
• Publication Date: 2015-05-18
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13325
• Languages: English
• ISSNs: 1600-6135

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajt13325-sec-0001" sec-type="section"> <p>Blood chimerism has been reported sporadically among visceral transplant recipients, mostly in association with graft‐vs‐host disease (GVHD). We hypothesized that a higher degree of mixed chimerism would be observed in multivisceral (MVTx) than in isolated intestinal (iITx) and isolated liver transplant (iLTx) recipients, regardless of GVHD. We performed a longitudinal prospective study investigating multilineage blood chimerism with flow cytometry in 5 iITx and 4 MVTx recipients up to one year posttransplant. Although only one iITx patient experienced GVHD, T cell mixed chimerism was detected in 8 out of 9 iITx/MVTx recipients. Chimerism was significantly lower in the four subjects who displayed early moderate to severe rejection. Pre‐formed high‐titer donor‐specific antibodies, bound <italic>in vivo</italic> to the circulating donor cells, were associated with an accelerated decline in chimerism. Blood chimerism was also studied in 10 iLTx controls. Among nonsensitized patients, MVTx recipients exhibited greater T and B cell chimerism than either iITx or iLTx recipients. Myeloid lineage chimerism was present exclusively among iLTx and MVTx (6/13) recipients, suggesting that its presence required the hepatic allograft. Our study demonstrates, for the first time, frequent T cell chimerism without GVHD following visceral transplantation and a possible relationship with reduced rejection rate in MVTx recipients.</p> </sec> </abstract>