Stem cell transplantation and Kidney transplantation has been tried at few centers now as a form to minimize immunosuppression. But inducting with autologous mesenchymal stem cells is a novel thought. A randomized controlled trial just published in JAMA from China and Miami, Florida. A single center, prospective, open label, randomized study was done from 2008-2009. The intervention arm had patients inoculated with marrow derived autologous mesenchymal stem cells at the time of kidney repercussion and then 2 weeks later. They then received either low dose calcinuerin inhibitors or regular dose. The control group got anti IL-2 induction and standard dose calcineurins inhibitors.
Acute rejection at one year was the major outcome they measured. At 30 months,the patient and graft survival was same in both groups. Overall, there was less rejection, less infections and better renal function at one year in the stem cell arm compared to standard arm. Initial recovery of renal function after surgery was also faster in stem cell arm.
This study is a first of its kind and will spark some major centers in US to hopefully consider this modality to be tested again. Before we move to this as a true replacement for induction treatment, this needs to be reproduced at other centers.
Take a look. Hoping one of the renal journals might have a commentary on this soon
http://jama.ama-assn.org/content/307/11/1169.short
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