Quantity of donor tissue and rat allograft survival

Sun, Jing; Bishop, Gail; Wang, C.; Wang, L.; McCaughan, Geoffrey W.; Sheil, Ross

doi:10.1016/s0041-1345(96)00494-0

Cited by 9 publications

(2 citation statements)

References 3 publications

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“…An explanation for the protective effect of an oversized graft might be an increased donor antigen load. This may overwhelm the immune system, and drive it into a high‐dose or activation‐induced tolerogenic profile (47–49). Our findings are also consistent with two other published studies of living and deceased donor graft recipients, in which the incidence of acute and chronic graft rejection was increased in recipients of a lower nephron mass (50, 51).…”

Section: Discussionmentioning

confidence: 99%

The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation

Giuliani

Gamba

Chokshi

et al. 2009

Pediatric Transplantation

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In pediatric kidney transplantation, the effect of inadequate nephron dosing on graft survival remains undetermined. The aim of this study was to assess the use of D/R BSA, as a reliable indicator of adequate nephron dosing, and eventually a tool to optimize pediatric graft allocation. Following Institutional Review Board approval, we reviewed deceased donor pediatric kidney transplantation (N = 156). We divided patients into three groups, based on D/R BSA: A < or =0.8; B 0.81-1.19; C > or =1.2. Five-yr graft survival rates in the groups were: A 82.0%; B 94.9%; C 97.1% (p = 0.01). Group C had the lowest rate of acute rejection, suggesting a protective effect of increased D/R BSA (group A = 35.7%, group B = 38.9%, group C = 18.8%; p = 0.029). The logistic regression analysis showed that decreased D/R BSA ratio is a risk factor for loss of graft function, at one and five yr [i.e., group A OR 6 (95% CI 1.14-39.30, p = 0.015) and OR 4.49 (95% CI 1.46-13.79, p = 0.009), respectively]. We conclude that for pediatric recipients, D/R BSA is a valuable adjunct when determining long-term graft survival. Its utility may avoid an alloimmune-independent risk factor, increasing the long-term protective value of a good matching policy

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Section: Discussionmentioning

confidence: 99%

The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation

Giuliani

Gamba

Chokshi

et al. 2009

Pediatric Transplantation

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“…Administration of donor leucocytes alone could not increase survival of a cardiac graft, but transplanting two hearts and two kidneys, with donor leucocytes, led to spontaneous acceptance and indefinite survival of the grafts [ 40 ]. Two or three hearts survived for 15.5 days, and two or three kidneys survived for 60 days and >100 days, respectively, while two hearts plus one or two kidneys prolonged their survival to >100 days [ 41 , 42 ].…”

Section: High Dose Tolerance In Transplantationmentioning

confidence: 99%

Liver Transplant Tolerance and Its Application to the Clinic: Can We Exploit the High Dose Effect?

Cunningham

Sharland

Bishop

2013

Clinical and Developmental Immunology

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The tolerogenic properties of the liver have long been recognised, especially in regard to transplantation. Spontaneous acceptance of liver grafts occurs in a number of experimental models and also in a proportion of clinical transplant recipients. Liver graft acceptance results from donor antigen-specific tolerance, demonstrated by the extension of tolerance to other grafts of donor origin. A number of factors have been proposed to be involved in liver transplant tolerance induction, including the release of soluble major histocompatibility (MHC) molecules from the liver, its complement of immunosuppressive donor leucocytes, and the ability of hepatocytes to directly interact with and destroy antigen-specific T cells. The large tissue mass of the liver has also been suggested to act as a cytokine sink, with the potential to exhaust the immune response. In this review, we outline the growing body of evidence, from experimental models and clinical transplantation, which supports a role for large tissue mass and high antigen dose in the induction of tolerance. We also discuss a novel gene therapy approach to exploit this dose effect and induce antigen-specific tolerance robust enough to overcome a primed T cell memory response.

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Long-term outcomes of adult-size and size-matched kidney transplants in small pediatric recipients

Amesty

Fernández

Espinosa

et al. 2020

Journal of Pediatric Urology

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Quantity of donor tissue and rat allograft survival

Cited by 9 publications

References 3 publications

The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation

The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation

Liver Transplant Tolerance and Its Application to the Clinic: Can We Exploit the High Dose Effect?

Long-term outcomes of adult-size and size-matched kidney transplants in small pediatric recipients

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