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Si M. Pham
Kenneth R. McCurry
Robert J. Keenan
Robert L. Kormos
Brack G. Hattler
Bartley P. Griffith
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Ann Thorac Surg 2000;69:345-350
© 2000 The Society of Thoracic Surgeons

Original Articles

Effects of donor bone marrow infusion in clinical lung transplantation

Si M. Pham, MDa,c, Abdul S. Rao, MD, DPhila,c, Adriana Zeevi, PhDb,c, Kenneth R. McCurry, MDa, Robert J. Keenan, MDa, J. David Vega, MDa, Robert L. Kormos, MDa, Brack G. Hattler, MD, PhDa, John J. Fung, MD, PhDa,c, Thomas E. Starzl, MD, PhDa,c, Bartley P. Griffith, MDa

a Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
b Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
c Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Address reprint requests to Dr Pham, Division of Cardiothoracic Surgery, University of Miami School of Medicine, PO Box 016960 (R-114), Miami, FL 33101
e-mail: spham{at}exchange.med.miami.edu

Presented at the Thirty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 25–27, 1999.

Background. We have demonstrated that donor cell chimerism is associated with a lower incidence of obliterative bronchiolitis (OB) in lung recipients, and that donor chimerism is augmented by the infusion of donor bone marrow (BM). We herein report the intermediate results of a trial combining the infusion of donor BM and lung transplantation.

Methods. Clinical and in vitro data of 26 lung recipients receiving concurrent infusion of donor bone marrow (3.0 to 6.0 x 108 cells/kg) were compared with those of 13 patients receiving lung transplant alone.

Results. Patient survival and freedom from acute rejection were similar between groups. Of the patients whose graft survived greater than 4 months, 5% (1 of 22) of BM and 33% (4 of 12) of control patients, developed histologic evidence of OB (p = 0.04). A higher proportion (but not statistically significant) of BM recipients (7 of 10, 70%) exhibited donor-specific hyporeactivity by mixed lymphocyte reaction assays as compared with the controls (2 of 7, 28%).

Conclusions. Infusion of donor BM at the time of lung transplantation is safe, and is associated with recipients’ immune modulation and a lower rate of obliterative bronchiolitis.


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Discussion
Ann. Thorac. Surg. 2000 69: 350. [Extract] [Full Text] [PDF]



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