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Tolerance protocol of living kidney transplant for developing countries through basic strategy of lymphocyte depletion

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World Journal of Transplantation 2022年第6期12卷 112-119页

作者： Sufi M Suhail Department of Renal Medicine Singapore General HospitalSingapore 169856Singapore Department of Clinical Research Duke-NUS Graduate Medical SchoolSingapore 169856Singapore

End-stage kidney failure(ESKD)is a global issue where kidney replacement therapy imposes enormous economic burden to people of developing countries,in addition to the severe limitations to the availability of hemodialysis and peritoneal dialysis *** best option of kidney transplantation also requires lifelong combination immunosuppressive medicines,the cost of which is equally comparable to lifelong dialysis.A strategy of achieving transplant tolerance that requires minimum immunosuppressive medicines,although in experimental stage,also requires state-of-art technology with costly medicines and *** is evidently beyond the reach of ESKD patients of developing ***,globally in developing countries,a need for an innovative but cost-effective tolerance protocol is a burning need for a successful transplant *** brief,transplant tolerance is defined as a state of donorspecific unresponsiveness to the allograft antigens without the need for ongoing pharmacologic immunosuppression or with a minimal *** state-of-art techniques involves:(1)A state of hematological chimera,for complete tolerance;(2)Prope or partial tolerance where immune-reactive T-lymphocytes are inhibited using monoclonal antibodies;and(3)Chimeric antigen receptor for T-regulatory(T-reg)cell therapy using genetically engineered T-reg cells targeting specific Tlymphocyte receptors for inducing *** our real-world experience in transplant management in post-transplant lympho-proliferative disorders(PTLD),we noticed frequently a drastic reduction in the need of immunosuppressive medicines following lympho-ablative therapy for *** recently published a case study on a real-world experience transplant case where we explained a partial or prope tolerance that developed after lymphocyte ablation therapy,following which the allograft was maintained with low dose dual standard immunosuppressive *** on this publication,we propose here an innovat

关键词： Renal allograft B and T lymphocytes depletion Tolerance protocol immunosuppressive medicines Living renal transplant

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