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Mesenchymal Stem Cells (MSCs) Transfusion for Desensitization of Positive Lymphocyte Cross Match (LCM) or Panel Reactive Antibodies (PRA) Before Kidney Transplantation – Outcome of 16 Cases

G. Saadi,1 K. Eweda,2 M. Hassaballa,1 F. Fadel,3 E. Aziz,2 M. Roshdi,1 M. El Ansary,4 I. Aziz,4 W. Ismail,5 A. Atef,1 S. Hamid.4

1Internal Medicine and Nephrology, Cairo University, Cairo, Egypt
2Nephrology, Army Hospital, Cairo, Egypt
3Pediatric Nephrology, Cairo University, Cairo, Egypt
4Clinical Pathology, Cairo University, Cairo, Egypt
5Pathology, Beni Sweif University, Beni Sweif City, Egypt.

Meeting: 2015 American Transplant Congress

Abstract number: C90

Keywords: Antibodies, Donor specific transfusion, Highly-sensitized, Stem cells

Session Information

Session Name: Poster Session C: Kidney Immunosuppression: Desensitization

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Immunomodulatory function of MSCs may correct positive PRA or LCM in highly-sensitized patients. We evaluate donor specific or 3rd party MSCs transfusion in 16 patients with +ve LCM and/or PRA. MSCs separated from 50 ml bone marrow aspirate, expanded, immunophenotyped by CD271+ and CD34-.

Relevant laboratory data in Table 1,

Demographic and laboratory data
Cases Age Sex CDC cross match PRA Transplant No
1st 34 M +ve B 40% I, 20% II 2nd
2nd 62 M +ve T&B 35% I, 30% II 1st
3rd 11 F +ve T&B 57.1% I, 13% II 1st
4th 39 M +ve B 20% 1st
5th 29 F +ve T&B 67.5% I 1st
6th 24 F +ve T&B 43% II 2nd
7th 24 M +ve T&B -ve 1st
8th 37 F +ve T&B 84% I, 40% II 1st
9th 49 F +ve T&B 100% I, 10% II 1st
10th 25 M +ve T&B 40% I, 10% II 1st
11th 28 M -ve 100%I, 100%II 2nd
12th 52 F +ve T&B 100%I, 100%II 1st
13th 54 F +ve T&B 88% 1st
14th 23 F +ve T&B 100%I, 100%II 2nd
15th 32 F -ve 60% 1st
16th 42 F -ve 100%I, 100%II 2nd
age in years, M = male, F = female, PRA class I , II or totaldesensitisation trials in Table 2.

Desensitisation procedures and Induction therapy
Rituximab IVIG PP Splenectomy Graft Nephrectomy Induction therapy
– (100mg/kg) 7 Yes Yes ATG 6 mg/kg day zero
– – – – – Basiliximab 20 mg on days zero& 4
– – – – – Basiliximab 20 mg on days zero& 4
– – – – – Basiliximab 20 mg on days zero& 4
– – 8 – – Basiliximab 20 mg on days zero& 4
– (100mg/kg) 6 – – Basiliximab 20 mg on days zero& 4
– – – – – Basiliximab 20 mg on days zero& 4
– – – – – ATG 6 mg/kg day zero
– – – – – ATG 6 mg/kg day zero
– – – – – ATG 6 mg/kg day zero
375 mg x 3 – 5 – – Basiliximab 20 mg on days zero& 4
– – 5 – – Basiliximab 20 mg on days zero& 4
– – 5 – – Basiliximab 20 mg on days zero& 4
– (100mg/kg) 5 – – Basiliximab 20 mg on days zero& 4
375 mg x 3 – – – – Basiliximab 20 mg on days zero& 4
– – 5 – Yes Basiliximab 20 mg on days zero& 4
IVIG following PP plasmapheresisAfter 15-45 million iv MSCs infusion, negative LCM and PRA were achieved in 14/16 cases. After transplantation 2/14 had cell and antibody mediated rejections. Graft survival for 6 – 60 months was comparable to 10 controls with history of +ve LCM . In conclusion: Donor specific or 3rd party MSCs transfusion is desensitization option.

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To cite this abstract in AMA style:

Saadi G, Eweda K, Hassaballa M, Fadel F, Aziz E, Roshdi M, Ansary MEl, Aziz I, Ismail W, Atef A, Hamid S. Mesenchymal Stem Cells (MSCs) Transfusion for Desensitization of Positive Lymphocyte Cross Match (LCM) or Panel Reactive Antibodies (PRA) Before Kidney Transplantation – Outcome of 16 Cases [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/mesenchymal-stem-cells-mscs-transfusion-for-desensitization-of-positive-lymphocyte-cross-match-lcm-or-panel-reactive-antibodies-pra-before-kidney-transplantation-outcome-of-16-cases/. Accessed May 9, 2025.

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