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Three-Year Outcome After HSCT with Subsequent KT from the Same Haploidentical Donor without Immunosuppression.

C. Schwarz,1 A. Lawitschka,2 G. Böhmig,3 E. Dauber,4 H. Greinix,5 N. Kozakowski,6 F. Mühlbacher,1 G. Berlakovich,1 T. Wekerle.7

1Dept. of Surgery, Div. of Transplantation, Medeical University of Vienna, Vienna, Austria
2St. Anna Children's Hospital, Vienna, Austria
3Dept. of Internal Medicine, Division of Nephrology, Medical University of Vienna, Vienna, Austria
4Dept. of Transfusion Medicine, Medical University of Vienna, Vienna, Austria
5Dept of Internal Medicine, Div of Hematology, Medical University of Graz, Graz, Austria
6Dept. of Clinical Pathology, Medical University of Vienna, Vienna, Austria
7Section of Transplantation Immunology, Dept. of Surgery, Medical University of Vienna, Vienna, Austria.

Meeting: 2016 American Transplant Congress

Abstract number: D91

Keywords: Bone marrow transplantation, Kidney transplantation, Tolerance

Session Information

Date: Tuesday, June 14, 2016

Session Name: Poster Session D: Clinical Science: Tolerance: Clinical Studies

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

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Allogeneic hematopoietic stem cell transplantation (HSCT) can lead to donor-specific tolerance. Patients reported in the literature that underwent kidney transplantation (KT) after a previous HSCT from the same haploidentical donor typically received short-term immunosuppression, mainly for safety reasons and concerns of triggering graft-versus-host-disease. We describe the three-year outcome of a 22-year-old patient who developed chronic kidney failure after receiving chemotherapy, local irradiation and a haploidentical HSCT from his father for the treatment of metastatic rhabdomyosarcoma. Five years after HSCT, with the patient in full remission, he received a pre-emptive kidney transplant from his father. Steroid treatment, which had been prescribed for the underlying kidney disease, was discontinued within two months post-kidney transplant. No de novo immunosuppression was given as the patient was determined to be fully chimeric and the avoidance of immunosuppression was considered to be of potential benefit in a patient with previous malignancy. Graft function was excellent throughout the follow-up (36 months post KT: sCreatinine: 1.18 mg/dl, GFR 79.9 ml/min/1.73[sup2]). Surveillance biopsies performed one and twelve months after transplantation confirmed the absence of rejection (BANFF g0, i0, ti0, t0, ah0, cg0, ci0, ct0, mm0, ptc0). To the best of our knowledge, this is one of the first cases of kidney transplantation from the same donor after previous haploidentical HSCT without the use of any de novo immunosuppression. Our results suggest that immunosuppression can be avoided in such cases.

CITATION INFORMATION: Schwarz C, Lawitschka A, Böhmig G, Dauber E, Greinix H, Kozakowski N, Mühlbacher F, Berlakovich G, Wekerle T. Three-Year Outcome After HSCT with Subsequent KT from the Same Haploidentical Donor without Immunosuppression. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Schwarz C, Lawitschka A, Böhmig G, Dauber E, Greinix H, Kozakowski N, Mühlbacher F, Berlakovich G, Wekerle T. Three-Year Outcome After HSCT with Subsequent KT from the Same Haploidentical Donor without Immunosuppression. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/three-year-outcome-after-hsct-with-subsequent-kt-from-the-same-haploidentical-donor-without-immunosuppression/. Accessed March 3, 2021.

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