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Effect of Reverse Chimerism on Rejection in Clinical Transplantation

Bolado, Pedro MD; Landin, Luis MD, PhD

doi: 10.1097/01.sap.0000437314.05306.36
Transplantation Surgery and Research

Abstract: Chimerism may enable allografts to survive when immunosuppressive therapy is administered at low levels or is even absent. Reverse chimerism (RC) is focused on intragraft chimerism that repopulates the allograft with cells of recipient origin. We aimed to identify and analyze current clinical evidence on RC and the presence of endothelial RC and tissue-specific RC. A total of 33 clinical reports on cardiac, kidney, liver, and lung transplants published between 1972 and 2012 that focused on RC were included in a systematic review. Liver allografts presented with the highest percentage of endothelial RC and lung allografts by far the lowest. Tissue-specific RC was present in most of the recipients, but at very low levels. There were also cardiac and kidney allografts with chimerism, but the functionality of the cells of recipient origin was questionable. We were unable to determine whether RC was a trigger for or a result of acute rejection. Further clinical research should focus on outcomes to evaluate the clinical relevance of this form of chimerism in transplantation.

From the Division of Plastic and Reconstructive Surgery, Hospital Universitario “La Paz,” Madrid, Spain.

Received July 17, 2013, and accepted for publication, after revision, August 29, 2013.

Conflicts of interest and sources of funding: none declared.

Both authors made their own contribution to the writing of the final manuscript; they also contributed to data recovery and analysis, writing, and reviewing the paper.

Reprints: Luis Landin, MD, PhD, Plastic and Reconstructive Surgery Division, University Hospital “La Paz,” Paseo de la Castellana 261, 28046 Madrid, Spain. E-mail: landinsurgery@gmail.com.

Both authors made their own contribution to the writing of the final manuscript; they also contributed to data recovery and analysis, writing, and reviewing the paper.

© 2013 by Lippincott Williams & Wilkins