[Introduction] Multilineage chimerism and long term acceptance of renal or cardiac allografts has been produced in non-human primates conditioned with pretransplant total body irradiation (TBI), thymic irradiation (TI) and ATG; splenectomy and DBM on the day of organ transplantation; and a 4-week post transplant course of cyclosporine (CYA). Previous studies demonstrated that removal of either DBM, TBI or CYA from the regimen resulted in allograft rejection within 2-8 weeks. The current studies were undertaken to evaluate the role of splenectomy in the protocol. [Method] Four renal allograft recipients received the entire conditioning regimen except for splenectomy. Another six recipients received the full protocol with (n=3) or without (n=3) splenectomy but renal allograft placement was delayed until 4 months later. [Results] In contrast to our previous observations of no alloantibody production and long term (>190days) organ allograft survival in 82% of recipients conditioned with the full regimen (Group A), monkeys conditioned without splenectomy rejected their allografts by day 117 and anti-donor antibody was detected in two of two recipients tested (Group B). In the six monkeys treated with delayed kidney transplantation until 4 months, three recipients without splenectomy (Group C) developed anti-donor antibody and rejected kidney allografts immediately after transplantation (0, 7, 12 days). None of three monkeys with splenectomy (Group D) developed anti-donor antibody. [Conclusion] In our current regimen, splenectomy appears to be essential for long term allograft survival. The development of donor specific alloantibody in all non-splenectomized recipients tested suggests inadequate control of B cell responses prevents induction of allograft tolerance in these animals.
Affiliations
Massachusetts General HospitalDepartment of Surgery
Citations
APA
Chicago
FWB
Poncelet, A., Kawai, T., Ko, D., Wee, S. L., Boskovic, S., Hong, H. Z., Winn, H., Colvin, R., Sachs, D., & Cosimi, A. B. (1998). The role of splenectomy in a non-lethal preparative regimen for induction of tolerance in non-human primates. Transplantation, 66(8), S54. https://hdl.handle.net/2078.5/112118 (Original work published 1998)