12/25/2023 0 Comments Chimera syndrome![]() Her mother Carol said, “I thought she was joking, but she started crying.” Carol said she was there when the kids were born and saw them come out. Lydia returned home to retrieve photos of her pregnancies, births, and the children’s birth certificates. DNA is 100 percent foolproof, and it doesn’t lie.” Lydia Fairchild fights for her children When Lydia said she knew she’d given birth to the children, a social worker said, “Nope. The DNA test results showed that the children and Jamie were related, but according to them, it was impossible for Lydia to be their mother. Washington Department of Social Services workers called Lydia in to their offices and began asking questions as if she was a criminal suspect. DNA tests intended to confirm that she and her boyfriend Jamie Townsend were the biological parents showed that Jamie was indeed the father of the children, but Lydia wasn’t their mother. Data and materials availability: The FCRx preparation is available from the authors, who will process samples with cost recovery under FDA approval.In 2002 when, out of work, pregnant, and separated from her children’s father, Lydia Fairchild applied for government aid in Washington state for her three children, she got the shock of her life. are authors on US patent number 5772994, “Hematopoietic facilitatory cells and their potential uses.” The other authors declare that they have no competing interests. has equity interest in Regenerex, LLC, a start-up biotech company. contributed to protocol design, regulatory oversight, data analysis, and product development. contributed to protocol design and data interpretation and S.T.I. performed, supervised, and analyzed the immunophenotyping and immunologic function assays G.H. contributed to study design, data interpretation, and product development M.J.E. contributed to statistical design, protocol development, and implementation B.K. contributed to protocol design and data interpretation D.J.T. contributed to protocol design, implementation, and data analysis R.H. contributed to conduct of the clinical trial and writing of the paper K.R. contributed to data analysis and writing of the paper L.G. contributed to conduct of the clinical trial and writing of the paper J.M. contributed to study design, conduct of the clinical trial, data analysis, and writing of the paper M.A. ![]() Keck Foundation and the American Society of Transplant Surgeons Collaborative Scientist Award. Funding: Supported by NIH R01 DK069766 the Department of the Army, Office of Army Research: the National Foundation to Support Cell Transplant Research the W. DeLautre for manuscript preparation, and I. Shirwan for review of the manuscript and helpful comments, C. These results suggest that manipulation of a mobilized stem cell graft and nonmyeloablative conditioning represents a safe, practical, and reproducible means of inducing durable chimerism and donor-specific tolerance in solid organ transplant recipients. None of the recipients produced anti-donor antibody or exhibited engraftment syndrome or graft-versus-host disease. Five subjects experienced durable chimerism, demonstrated immunocompetence and donor-specific tolerance by in vitro proliferative assays, and were successfully weaned off all immunosuppression 1 year after transplant. One subject developed viral sepsis 2 months after transplant and experienced renal artery thrombosis. Two subjects exhibited transient chimerism and were maintained on low-dose tacrolimus monotherapy. The conditioning was well tolerated, with outpatient management after postoperative day 2. Multilineage chimerism at 1 month ranged from 6 to 100%. The absolute neutrophil counts reached a nadir about 1 week after transplant, with recovery by 2 weeks. HLA match ranged from five of six loci with related donors to one of six loci with unrelated donors. ![]() Subjects ranged in age from 29 to 56 years. Eight recipients of human leukocyte antigen (HLA)–mismatched kidney and FC/HSC transplants underwent conditioning with fludarabine, 200-centigray total body irradiation, and cyclophosphamide followed by posttransplant immunosuppression with tacrolimus and mycophenolate mofetil. We developed an approach using a bioengineered mobilized cellular product enriched for hematopoietic stem cells (HSCs) and tolerogenic graft facilitating cells (FCs) combined with nonmyeloablative conditioning this approach resulted in engraftment, durable chimerism, and tolerance induction in recipients with highly mismatched related and unrelated donors. The toxicity of chronic immunosuppressive agents required for organ transplant maintenance has prompted investigators to pursue approaches to induce immune tolerance.
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