We have postulated that the donor leukocyte microchimerism plays a seminal role in the acceptance of allografts by inducing and perpetuating variable degree of donor-specific nonreactivity in longsurviving organ recipients. Limited information is available, however, concerning the phenotype and function of these chimeric cells in humans. The unequivocal presence of donor dendritic cells (DCs), a prominent lineage in the microchimerism observed in rodents and clinical organ recipients, was difficult to demonstrate in bone marrow (BM)-augmented organ transplant recipients. This enigma was resolved by the recent description of a method for propagating circulating human DCs from their progenitors by culture in a medium enriched with granulocyte-macrophage colony-stimulating factor and interleukin 4, a condition known to inhibit outgrowth of monocytes, thus providing a selective growth advantage to committed progenitors of the myeloid lineage. Cells from BM-augmented organ recipients and normal control subjects harvested from 12-to 14-day cultures exhibited dendritic morphology and potent allostimulatory capacity. Using appropriate primers, the presence of donor DNA was verified by polymerase chain reaction within the lineage null /class II bright sorted DC. Phenotypic analysis of cultured DCs from BM-augmented patients, unlike that of controls, exhibited a marked down-regulation of B7-1 (CD80) while retaining normal levels of expression of B7-2 (CD86) cell surface molecules. The presence of donor DNA was also confirmed by polymerase chain reaction in individually sorted lineage + (T, B, and NK) cells and macrophages, suggesting that the chimerism in BM-augmented patients is multilineage. The presence of progenitors of donor DCs in the peripheral blood of BM-augmented patients further substantiates the already convincing evidence of stem cell engraftment. The diffuse migration of passenger leukocytes from transplanted organs into the recipient has been proposed as the first step toward allograft acceptance and the induction of variable degrees of donor-specific tolerance (1-4). In this paradigm, acceptance of various organs hinges on the quantity and quality of tolerogenic resident migratory cells with a critical role for cells of the dendritic leukocyte lineage (5-11) first characterized by Steinman and Cohn (12,13). Although dendritic cells (DCs * ) and their progenitors have been isolated from various mouse (14-18) and rat (19) tissues, such studies were not possible in humans until Romani et al. (20) described a modified culture technique for propagation of DCs from their progenitors in human blood. We argue that demonstration of these progenitors in the presence of other lineages in peripheral blood mononuclear cells (PBMCs) would provide strong evidence for engraftment of stem cells in organ recipients given adjunct bone marrow (BM) infusion (21). Added to previous observations in rodents (22)(23)(24)(25)(26), such findings would explain the long-term perpetuation of multi-lineage donor cell chimerism i...