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	Induction Therapy With Autologous Mesenchymal Stem Cells in Living-Related Kidney Transplants A Randomized Controlled Trial
	Tan, Jianming ; Tan JM(谭建明) ; Wu, Weizhen ; Xu, Xiumin ; Liao, Lianming ; Zheng, Feng ; Messinger, Shari ; Sun, Xinhui ; Chen, Jin ; Yang, Shunliang ; Cai, Jinquan ; Gao, Xia ; Pileggi, Antonello ; Ricordi, Camillo
	2012-03-21
关键词	AMYOTROPHIC-LATERAL-SCLEROSIS SOLID-ORGAN TRANSPLANTATION VERSUS-HOST-DISEASE STROMAL CELLS RENAL-TRANSPLANTATION GRAFT FUNCTION IN-VITRO PHASE-I DONOR SURVIVAL
英文摘要	Context Antibody-based induction therapy plus calcineurin inhibitors (CNIs) reduce acute rejection rates in kidney recipients; however, opportunistic infections and toxic CNI effects remain challenging. Reportedly, mesenchymal stem cells (MSCs) have successfully treated graft-vs-host disease. Objective To assess autologous MSCs as replacement of antibody induction for patients with end-stage renal disease who undergo ABO-compatible, cross-match-negative kidney transplants from a living-related donor. Design, Setting, and Patients One hundred fifty-nine patients were enrolled in this single-site, prospective, open-label, randomized study from February 2008-May 2009, when recruitment was completed. Intervention Patients were inoculated with marrow-derived autologous MSC (1-2 x 10(6)/kg) at kidney reperfusion and two weeks later. Fifty-three patients received standard-dose and 52 patients received low-dose CNIs (80% of standard); 51 patients in the control group received anti-IL-2 receptor antibody plus standard-dose CNIs. Main Outcome Measures The primary measure was 1-year incidence of acute rejection and renal function (estimated glomerular filtration rate [eGFR]); the secondary measure was patient and graft survival and incidence of adverse events. Results Patient and graft survival at 13 to 30 months was similar in all groups. After 6 months, 4 of 53 patients (7.5%) in the autologous MSC plus standard-dose CNI group (95% CI, 0.4%-14.7%; P=.04) and 4 of 52 patients (7.7%) in the low-dose group (95% CI, 0.5%-14.9%; P=.046) compared with 11 of 51 controls (21.6%; 95% CI, 10.5%-32.6%) had biopsy-confirmed acute rejection. None of the patients in either autologous MSC group had glucorticoid-resistant rejection, whereas 4 patients (7.8%) in the control showing increased eGFR levels during the first month postsurgery group did (95% CI, 0.6%-15.1%; overall P=.02). Renal function recovered faster among both MSC groups showing increased eGFR levels during the first month after surgery than the control group. Patients receiving standard-dose CNI had a mean difference of 6.2 mL/min per 1.73 m(2) (95% CI, 0.4-11.9; P=.04) and those in the low-dose CNI of 10.0 mL/min per 1.73 m(2) (95% CI, 3.8-16.2; P=.002). Also, during the 1-year follow-up, combined analysis of MSC-treated groups revealed significantly decreased risk of opportunistic infections than the control group (hazard ratio, 0.42; 95% CI, 0.20-0.85, P=.02) Conclusion Among patients undergoing renal transplant, the use of autologous MSCs compared with anti-IL-2 receptor antibody induction therapy resulted in lower incidence of acute rejection, decreased risk of opportunistic infection, and better estimated renal function at 1 year.; Key Science Research Project of Fujian Province, China [2009Y4001]; Key Laboratory of Fujian Province, China [2008J1006]
语种	英语
出版者	AMER MEDICAL ASSOC
内容类型	期刊论文
源URL	[http://dspace.xmu.edu.cn/handle/2288/16141]
专题	医学院－已发表论文
推荐引用方式 GB/T 7714	Tan, Jianming,Tan JM,Wu, Weizhen,et al. Induction Therapy With Autologous Mesenchymal Stem Cells in Living-Related Kidney Transplants A Randomized Controlled Trial[J],2012.
APA	Tan, Jianming.,谭建明.,Wu, Weizhen.,Xu, Xiumin.,Liao, Lianming.,...&Ricordi, Camillo.(2012).Induction Therapy With Autologous Mesenchymal Stem Cells in Living-Related Kidney Transplants A Randomized Controlled Trial..
MLA	Tan, Jianming,et al."Induction Therapy With Autologous Mesenchymal Stem Cells in Living-Related Kidney Transplants A Randomized Controlled Trial".(2012).

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