Abstract
In this review, we summarized the latest results from the interventional clinical trials on inducing clinical tolerance in the recipients of human leukocyte antigen (HLA)-matched or mismatched living donor kidney transplantation via establishment of either transient or durable donor chimerism by hematopoietic stem cell (HSC)-based cell therapies. The protocols utilized by the three medical centers in the United States are different in the donor cells composition of hematopoietic stem cells transplantation (HSCT) and its timing, and the conditioning regimen prepared for the transplantation. Tolerant recipients from the clinical trials benefited from better long-term outcome, improved quality of life and reductions in lifetime healthcare expenses compared with Standard of Care recipients on conventional immunosuppression. Durable chimerism is indispensable to achieve immunologic tolerance to kidney transplantation and to protect against recurrence of the original renal disease in HLA-mismatched kidney transplant recipients by concomitant HSCT.
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