HLA-mismatched renal transplantation without maintenance immunosuppression Academic Article uri icon


MeSH Major

  • Bone Marrow Transplantation
  • Kidney Failure, Chronic
  • Kidney Transplantation
  • Transplantation Chimera
  • Transplantation Tolerance


  • Five patients with end-stage renal disease received combined bone marrow and kidney transplants from HLA single-haplotype mismatched living related donors, with the use of a nonmyeloablative preparative regimen. Transient chimerism and reversible capillary leak syndrome developed in all recipients. Irreversible humoral rejection occurred in one patient. In the other four recipients, it was possible to discontinue all immunosuppressive therapy 9 to 14 months after the transplantation, and renal function has remained stable for 2.0 to 5.3 years since transplantation. The T cells from these four recipients, tested in vitro, showed donor-specific unresponsiveness and in specimens from allograft biopsies, obtained after withdrawal of immunosuppressive therapy, there were high levels of P3 (FOXP3) messenger RNA (mRNA) but not granzyme B mRNA.

publication date

  • January 24, 2008



  • Academic Article



  • eng

PubMed Central ID

  • PMC2819046

Digital Object Identifier (DOI)

  • 10.1056/NEJMoa071074

PubMed ID

  • 18216355

Additional Document Info

start page

  • 353

end page

  • 61


  • 358


  • 4