Commentary on “Combined treatment with regulatory T cells and vascularized bone marrow transplantation creates mixed chimerism and donor-specific tolerance to vascularized composite allografts without cytoreductive conditioning”

Abstract

Transplantation of vascularized composite allografts (VCAs) could significantly affect the liver of the approximately 7 million Americans every year. These Americans would benefit from transplantation because they had undergone or need to undergo reconstructive surgery as the result of oncologic procedures, congenital anomalies, and trauma [ [1] Gander B. Brown C.S. Vasilic D. et al. Composite tissue allotransplantation of the hand and face: a new frontier in transplant and reconstructive surgery. Transplant Int. 2006; 19: 868 Crossref PubMed Scopus (77) Google Scholar ]. Just as important, it may also help bring us a step closer to the “Holy Grail” of transplantation, which is the induction of donor-specific immunologic tolerance. The reason is because, to achieve a state of tolerance, the most promising approach appears to be the creation of mixed hematopoietic chimerism [ [2] Bradley J.A. Induction of transplant tolerance through mixed hematopoietic chimerism. Am J Transplant. 2012; 12: 1073 Crossref PubMed Scopus (3) Google Scholar ]. The significance of VCA transplantation lies in the fact that by definition, VCA already contain hematopoietic tissue, which can lead to chimerism with reduced conditioning. Combined treatment with regulatory T cells and vascularized bone marrow transplantation creates mixed chimerism and induces donor-specific tolerance to vascularized composite allografts without cytoreductive conditioningJournal of Surgical ResearchVol. 178Issue 2PreviewCotreatment with regulatory T cells (Treg) and conventional allogeneic bone marrow transplantation (BMT) successfully induced durable chimerism and tolerance to nonvascularized skin allografts without cytoreductive conditioning in mice. We sought to determine whether Treg treatment combined with vascularized BMT (VBMT) could create mixed chimerism and induce tolerance to vascularized composite allografts (VCAs) without cytoreductive conditioning in rats. Full-Text PDF