NEJM, Vol 358, pp 362-368, 2008
Tolerance and chimerism after renal and hematopoietic-cell transplantation
Scandling JD, et al
We describe a recipient of combined kidney and hematopoietic-celltransplants from an HLA-matched donor. A post-transplantationconditioning regimen of total lymphoid irradiation and antithymocyteglobulin allowed engraftment of the donor's hematopoietic cells.The patient had persistent mixed chimerism, and the functionof the kidney allograft has been normal for more than 28 monthssince discontinuation of all immunosuppressive drugs. Adverseevents requiring hospitalization were limited to a 2-day episodeof fever with neutropenia. The patient has had neither rejectionepisodes nor clinical manifestations of graft-versus-host disease.
