Stem Cells Improve Kidney Transplant Outcomes
Stem cells in place of antibody induction therapy reduces rejection and infection
WEDNESDAY, March 21 (HealthDay News) -- Patients with end-stage renal disease receiving living-related kidney transplants with autologous mesenchymal stem cells (MSCs) instead of antibody induction therapy have improved outcomes, according to a study published in the March 21 issue of the Journal of the American Medical Association.
Jianming Tan, M.D., Ph.D., of Xiamen University in Fuzhou, China, and colleagues enrolled 159 patients undergoing live kidney transplants. Patients were inoculated with marrow-derived autologous MSCs and were treated with calcineurin inhibitors (CNIs) at a standard or low dose (53 and 52 patients, respectively), or with standard dose CNIs plus anti-interleukin-2 receptor antibody (51 patients).
The researchers found that, at 13 to 30 months, patient and graft survival was similar in all groups. After six months, biopsy-confirmed acute rejection was seen in 7.5 percent of the autologous MSC plus standard-dose CNI group, 7.7 percent of the low-dose group, and 21.6 percent of controls. Glucorticoid-resistant rejection was not seen in any patients in either autologous MSC group, but was seen in 7.8 percent of patients in the control group who showed increased estimated glomerular filtration rate (eGFR) levels during the first month post-surgery. Compared with the control group, renal function recovered faster among patients in both MSC groups, showing increased eGFR levels during the first month after surgery. Combined analysis of MSC-treated groups revealed significantly decreased risk of opportunistic infections versus the control group during one year of follow-up (hazard ratio, 0.42).
"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 one year," the authors write.