HLA-Mismatched Kidney Transplantation Possible without Maintenance Immunosuppression.

Researchers have expanded a trial that in 2008 found that four out of five patients with ESRD who received combined bone marrow and kidney transplants from HLA single-haplotype mismatched living related donors could discontinue all immunosuppressive therapy 9 to 14 months after transplantation and maintain stable renal function for 2 to 5 years. Results from a second group of five patients suggest that the current B-cell depletion regimen adequately controls the development of donor-specific antibodies but that additional modifications are needed to overcome engraftment syndrome. The findings are published in the New England Journal of Medicine.