Transcript Joshua Miller

Non-Chimeric HLA Identical
and
Chimeric HLA Disparate
Renal Transplant Tolerance
HLA Identical Non-Chimeric
HLA Disparate Chimeric
HLA Identical Non-Chimeric Tolerance
Donor (D)/Recipient (R)
Pt#
Pre-Op
Diagnosis of
Native Disease
Latest Tx
Peak
Critical Tx
Current
Biopsy
Current Daily IS Dose
PRA PreBiopsy Results &
Cr
Results and
Tx
Time Post-Op
Time Post-Op
Age
D/R
Sex
D/R
Race
1
49/51
F/M
Cau
Polycystic
5%
1.2
Banff 1A – 36 mos
Neg – 60 mos
SRL 2mg
2
56/54
M/M
Cau
Multicystic
9%
1.1
Neg – 36 mos
(Tol)
Neg – 60 mos
3
45/46
M/F
Cau
IgA Neph
29%
0.8
Banff 1A – 25 mos
4
39/41
F/M
Hisp
DM II
0%
1.6
Banff 1A – 36 mos
5
33/39
F/M
Cau
IgA Neph
0%
1.4
6
35/38
M/M
Cau
IgA Neph
0%
8
21/24
M/M
Hisp
Obstructive
9
30/39
M/M
Cau
11
67/65
F/M
Cau
Mos
off IS
Maximum %
Microchimerism in
Year 1 Post-Op
Blood
Bone
Marrow
12
0.016
0.02
0 (Tol)
42
0.1
0
Neg – 60 mos
MMF 1gm 2x
1
0.1
0
Neg – 60 mos
Prograf 2mg 2x
MMF 1gm 2x
12
0.01
0.03
Neg – 36 mos
(Tol)
0 (Tol)
34
2.3
NT
1.2
Neg – 36 mos
(Tol)
0 (Tol)
34
1.7
3
11%
0.9
Neg – 36 mos
(Tol)
0 (Tol)
30
0.47
8.5
IgA Neph
0%
1.4
Neg – 36 mos
(Tol)
0 (Tol)
28
0.01
NT
HTN
0%
1.3
Neg – 36 mos
(Tol)
0 (Tol)
24
4.3
5.2
Myfortic 750 mg 2x
Tacro 2mg 2x
0
0
0
Mild chronic
interstitial
changes – 36
mos
12
37/29
M/M
Cau
Dysgenesis
0%
1.5
Banff 2B – 1 mo
13
49/53
M/F
Cau
Pyelo-nephritis
20%
0.9
Neg – 36 mos
(Tol)
0 (Tol)
17
0.13
NT
16
43/53
F/M
Cau
DM II
0%
1.5
Banff 1A – 26 mos
Tacro 1mg 2x
Myfortic 720mg 2x
2
0.07
0.08
HLA Disparate Chimeric Tolerance
Pt#
Age Sex
D/R D/R
Donor
Relation- Pre-operative
KD Tx
HLA
PRA
Source
ship
diagnosis of
Date
match
?Sibling, native disease
parent, child
FCRx Product
Composition
αβ T
cells
CD34
Current
AntiTime off all
% Chimerism Current %
donor
Immunoat 1 month Chimerism
Allosuppression
FC
antibody
1
44/49 F/M
0
2/09
IC
5/6
Related
Membranous
0.963
0.896 0.467
30
0
None
None
2
25/55 M/M
6
4/09
MPB
3/6
Related
Hypertension
3.80
2.53
6.65
95
0
None
None
3
49/42 M/M
19
5/09
MPB
1/6
Unrelated
Polycystic
kidney disease
3.80
3.60
3.96
100
100
None
42 months
4
51/28 M/M
0
6/09
MPB
3/6
Related
Alports
Syndrome
1.94
1.00
1.55
6
0
None
None
5
51/40 F/M
0
2/10
MPB
1/6
Unrelated
Chronic GN
3.80
3.94
3.68
100
100
None
35 months
6
45/39 M/F
14
3/10
MPB
2/6
Unrelated
Reflux:2nd Tx
3.80
8.59
12.30
100
100
None
34 months
7
38/35 M/M
0
4/10
MPB
3/6
Related
Hypertension
3.80
16.90 12.20
100
100
None
33 months
8
43/45 M/F
16
7/10
MPB
1/6
Unrelated
Polycystic
kidney disease
3.80
12.60
100
100
None
30 months
8.06
Tolerance in HLA Identical RecipientsNon-Chimeric 7/12
Tolerance in HLA Disparate RecipientsChimeric 5/8
Life expectancy of a mouse ± 2½ years
Life expectancy of a human 78 .8 years
?