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• W2048792403 abstract "86 Donor bone marrow cell (DBMC) infusions have been proposed to enhance allograft survival. Aim of this clinical trial was to determine the effect of DBMC infusions on patient and graft survival after liver transplantation (LTX). DBMC (from vertebral bodies) were administered in 257 LTX recipients. In 432 LTX recipients donor vertebral bodies were not available (controls). Up to 1 × 109 DBMC/kg were infused in equal aliquots administered at day 5,11 (2 DBMC delayed; n=185), at day 5,14,21,28,90 (5 DBMC; n=36), or at day 0,11 (2 DBMC; n=36). Four year actuarial patient/graft survival (%) was 84.1/81.2 (2 DBMC delayed), 77.4/72.2 (5 DBMC), 74.8/69.2 (2 DBMC) and 79.0/66.1 (Controls). The 4 year results in controls were similar to the 3 year results reported by UNOS (77.4/66.4). Patient survival was not significantly different in all groups. Graft survival in the 2 DBMC delayed group was higher compared to the controls (p<0.001, Wilcoxon). Acute, biopsy proven, rejection was lower in the 2 DBMC delayed group (35.1%) vs. controls (43.3%; p<0.05). The incidence of multiple (3 or more) rejection episodes was 4.9% in the 2 DBMC delayed group, 11.6% in the control group (p=0.01), and 22.2% in the 5 DBMC group (p=0.001). Chronic rejection was 5.8% in the controls and 4.9% in the 2 DBMC delayed group (NS). Two or more biopsies positive for chronic rejection were observed in 0.5% in the 2 DBMC delayed group vs. 2.8% in the controls (NS). In contrast, a significantly higher incidence of chronic rejection was observed in the 5 DBMC group (27.8%). When the DBMC was infused at day 0,11 (2 DBMC group) the incidence of acute and chronic rejection was 50% and 13.9% respectively (NS vs. controls or 2 DBMC delayed). The incidence of EBV infections was higher in the controls and 2 DBMC group compared to the 2 DBMC delayed group (5.7 and 5.7 vs. 1.7 respectively; p<0.05). However PTLD was observed only in 3 cases (2 in the DBMC and 1 in the control groups, NS). The incidence of other infections (bacterial or viral) was not significantly different between groups. Similarly, no significant difference was observed in the distribution of causes of death or graft failure between groups. The incidence of GVHD was higher in the DBMC groups (3.1%) compared to the controls (0.5%; p=0.005), with the highest incidence observed in the 5 DBMC group (8.3%; p=0.001) compared to the 2 DBMC delayed (2.2%; p=0.05). The results indicate that timing of DBMC infusions can result in significantly different outcomes in LTX survival and can also affect the incidence of acute, chronic rejection as well as GVHD." @default.
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• W2048792403 date "1999-05-01" @default.
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• W2048792403 title "FOUR YEAR FOLLOW-UP OF HIGH-DOSE DONOR BONE MARROW INFUSIONS TO ENHANCE ALLOGRAFT SURVIVAL" @default.
• W2048792403 doi "https://doi.org/10.1097/00007890-199905150-00111" @default.
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