Tolerance and chimerism after renal and hematopoietic cell
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This document summarizes a case study on inducing tolerance and chimerism after renal transplantation. The case involved a 47-year-old man who received a preemptive kidney transplant from his 49-year-old brother. To induce immune tolerance, the patient was given hematopoietic cell infusions from the kidney donor before and after the transplant. This created a state of mixed chimerism where the patient's blood and immune cells were partially derived from the donor. The goal was for the donor's immune cells to promote tolerance by educating the patient's immune system in the thymus and lymphoid tissues.
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Tolerance and chimerism after renal and hematopoietic cell
- 1. CASE STUDY: TOLERANCE AND CHIMERISM AFTER RENAL AND HEMATOPOIETIC-CELL PRESENTATION BY: SHAHZENAN AL-AZZAWI VESILENUR ÇELIK
- 2. TEXT RESOURCES ▸ Main resource: Tolerance and Chimerism after Renal and Hematopoietic-Cell Transplantation by John D. Scandling ▸ Secondary resources: ▸ Induction of Tolerance through Mixed Chimerism by David H. Sachs1, Tatsuo Kawai2, and Megan Sykes. ▸ Blood Group Chimerism in Human Multiple Births Is Not Rare by Bob A. van Dijk, Dorret I. Boomsma, and Achile J.M. de Man
- 3. TOLERANCE AND CHIMERISM AFTER RENAL AND HEMATOPOIETIC-CELL JOURNAL INFORMATION ▸ Journal: the new England journal of medicine ▸ impact factor: 72.406 ▸ Publisher: Massachusetts Medical Society ▸ Publication history: 1812–present ▸ Frequency: weekly
- 4. TOLERANCE AND CHIMERISM AFTER RENAL AND HEMATOPOIETIC-CELL RESEARCH INFORMATION ‣ Qualitative research method: case study ‣ Publication date: January 24, 2008 ‣ Digital object identifier: 10.1056/NEJMoa074191 ‣ Title: Tolerance and Chimerism after Renal and Hematopoietic-Cell Transplantation ‣ authors: John D. Scandling, M.D., Stephan Busque, M.D., Sussan Dejbakhsh- Jones, M.S., Claudia Benike, B.S., Maria T. Millan, M.D., Judith A. Shizuru, M.D., Ph.D., Richard T. Hoppe, M.D., Robert Lowsky, M.D., Edgar G. Engleman, M.D., and Samuel Strober, M.D. ‣ Publishing institute: Stanford University School of Medicine, Stanford, CA.
- 5. INDUCTION OF TOLERANCE THROUGH MIXED CHIMERISM BACKGROUND ‣ Organ Transplant complication covered: graft-verses- host diseases (GVHD) and infection. ‣ Immune tolerance: is a state of unresponsiveness of the immune system to substances or tissue that have the capacity to elicit an immune response in given organism.
- 6. TEXT BACKGROUND ‣ Chimerae: a state where an organism has cells from two or more zygotes. ‣ Mixed chimerism: refers to a state in which the lymphohematopoietic system of the recipient of allogeneic (genetically different) hematopoietic stem cells comprises a mixture of host and donor cells. ‣ lymphohematopoietic system: responsible for producing (-poietic) lymphocytes (lympho-) and blood cells (hemato-). ‣ the hematopoietic chimerism that occurs after bone marrow transplantation carries with it transplantation tolerance for any other tissue or organ from the same donor.
- 7. TOLERANCE AND CHIMERISM AFTER RENAL AND HEMATOPOIETIC-CELL CASE ▸ The patient is a 47-year-old white man with end-stage renal disease of unknown origin at the time of preemptive kidney transplantation. (to avoid complications) ▸ The kidney donor was his 49-year-old brother.
- 8. TOLERANCE AND CHIMERISM AFTER RENAL AND HEMATOPOIETIC-CELL CASE: ▸ aim: inducing immunetolerance of organ transplant ▸ Method used: inducing persistent mixed blood and immune-cell chimerism by infusing hematopoietic cells from the organ donor before or after transplantation of organ ▸ Mechanism of action: the continued presence of organ donor’s immune cells in the recipient’s thymus and peripheral lymphoid tissue promotes and maintains immune tolerance.
- 9. THANK YOU FOR YOUR ATTENTION