Kidney transplantation after liver transplantation from the same donor: four cases of successful XXXX withdrawal.

@entity1 @entity6306 @entity228 @entity134 @entity1358 @entity1140 @entity230
BACKGROUND: Administration of corticosteroids to kidney recipients has hampered the complete clinical success of kidney transplantation. Because most organ transplantation in Japan is living-related, we had the experience of performing kidney transplantation (KT) after liver transplantation (LT) from the same donor in four @entity1 and successfully withdrew @entity228 administration. METHODS: Three pediatric and one adult @entity1 received kidney allografts from 3 to 10 months after LT from the same donor. The immunosuppressive regimen consisted of a corticosteroid and @entity1140 . The @entity134 was withdrawn after KT in all four @entity1 . After complete withdrawal of the @entity134 , DNA was extracted from two recipients and examined by polymerase chain reaction to detect microchimerism. A mixed lymphocyte reaction (MLR) and @entity1358 ( @entity1358 ) were performed to test for donor-specific @entity6306 . RESULTS: @entity134 withdrawal was successfully accomplished after KT in every @entity1 . No @entity134 -withdrawal-associated complications were observed. In the three pediatric @entity1 , remarkable catch-up growth was observed after @entity134 withdrawal. In the two @entity1 tested, donor DNA was not detected by polymerase chain reaction, suggesting the absence of microchimerism. MLR and @entity1358 showed that recipient lymphocytes reacted against donor lymphocytes at the same level as against the third-party lymphocytes. CONCLUSION: @entity134 withdrawal was successfully achieved in four kidney recipients who had received a liver allograft from the same donor. The MLR and @entity1358 findings indicated the absence of donor-specific @entity6306 in vitro. Although the precise mechanism is not yet clear, KT after LT from the same donor should be considered as a method that allows @entity230 to be withdrawn from the immunosuppressive regimen of KT.
