Unresponsiveness to a Kidney Graft After a Fully Matched Allogenic Bone Marrow Transplantation Combined With Low-Dose Tacrolimus Therapy: A Case Report

• Published in: Transplantation proceedings 2011-07, Vol.43 (6), p.2344-2346
• Main Authors: Álvarez, S, Boltansky, A, Alfaro, J, Sepúlveda, L, Ursu, M, Innocenti, G, Carvajal, D, Villamizar, G, Hurtado, M, Vukusich, A
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Bone marrow, stem cells transplantation. Graft versus host reaction; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft vs Host Disease - etiology; Humans; Immunosuppressive Agents - therapeutic use; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - surgery; Kidney Transplantation - immunology; Leukemia, Myeloid, Acute - surgery; Male; Medical sciences; Purpura, Thrombotic Thrombocytopenic - etiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Chimera; Transplantation Tolerance; Treatment Outcome
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.06.005

Abstract We present the case of a patient with past medical history of acute mieloblastic leukemia treated with a related, fully match alogenic bone marrow transplantation (BMT). He presented after BMT treatment graft versus host disease (GVHD) and thrombotic thrombocytopenic purpura. He also developed end-stage renal disease that required renal replacement therapy. A preemptive kidney transplant was performed. The haematopoiesis were in complete chimera and the patient developed tolerance to the kidney graft, requiring only minimal immunossupression because of his GVHD.