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Bone Marrow With Heart And Lung Transplants Reduces Rejection Of Transplanted Organs, Reports University Of Pittsburgh

s, acute cellular rejection in the first six months occurred in 38 percent of those who received bone marrow, compared to 82 percent of those who did not. Most of the rejection episodes in the group of bone marrow-augmented patients were mild as compared to moderate to severe in the recipients who did not receive bone marrow. There were no differences in the incidence of chronic rejection for the two groups of heart recipients.

In lung transplant patients, the most significant result was a reduced incidence of chronic rejection, a process that prevents air to pass through the lung's bronchioles. Chronic rejection occurred in 9 percent of the bone marrow patients and in 42 percent of those who did not receive bone marrow. In addition, those lung patients receiving bone marrow had higher measures of donor-specific hyporeactivity. This indicates that the recipient's immune defense is capable of fighting unwanted infections but is less likely to initiate an attack against the donor organ.

In studies to detect chimerism in a small subset of patients a year after transplantation, levels appeared to be higher in those who received bone marrow. The safety of the bone marrow procedure was also a parameter studied. Patients were not pre-treated with irradiation to "make space" for the bone marrow, nor was the bone marrow modified in any way. As a result, the researchers believe the risk of graft vs. host disease (GVHD) was minimized. GVHD, a common complication of bone marrow transplantation, occurs when donor immune cells attack recipient tissues.

"The results in these patients who received the extra boost of donor immune system cells indicate the procedure is safe and augments the cellular environment we believe is necessary for long-term acceptance of a transplanted organ. Chimerism is a prerequisite for but not synonymous with tolerance," Dr. McCurry reported.

The study of combined solid organ and bone marrow transplants is the clinical centerpi
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Contact: Lisa Rossi
rossiL@msx.upmc.edu
412-624-2607
University of Pittsburgh Medical Center
24-Apr-1999


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