Researchers have injected bone marrow into the thymus of pediatric heart transplant recipients in hopes of inducing tolerance.
The trial, conducted at the University of Pittsburgh and Children's Hospital of Pittsburgh, marks the first time injections into the thymus have been tried in humans. "The idea behind infusing donor bone marrow is to fool the recipient's T cells that are being educated in the thymus into thinking that the donor bone marrow is 'self' as well," the University of Pittsburgh Medical Center reported.
Routine biopsies taken from the transplanted hearts of the seven children who received bone marrow indicated that "their immune systems were not sounding the usual alarms, as measured by the number of activated recipient T cells infiltrating the organs," UPMC said. Three of the seven patients, but only one of eight control patients, had some evidence of donor-specific hyporeactivity.
"Animal studies to date gave us every indication that the time was right for a human trial, and we have proven the procedure is safe and feasible. Time will tell if we are able to effectively induce tolerance in these children," said Steven A. Webber, MBChB, medical director of the pediatric heart/lung transplant program at Children's Hospital of Pittsburgh.
Findings from the study were reported at the recent annual scientific meetings of the American Society of Transplantation and the American Society of Transplant Surgeons.
In another presentation, Robert J. Corry, MD, director of pancreas transplantation at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute, reported that patients who had kidney-pancreas transplants with donor bone marrow augmentation were more likely to be weaned from steroid medications, had fewer episodes of rejection, and had better pancreas graft function and survival than patients who did not receive marrow. Three months after transplantation, rejection led to removal of the pancreas in none of the 53 patients who had received bone marrow and in seven of the 98 patients who did not receive bone marrow.
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University of Pittsburgh Medical Center press release
www.upmc.edu/NewsBureau/bonemarrow.htm
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