Original Article
Kidney-Induced Cardiac Allograft Tolerance in Miniature Swine is Dependent on MHC-Matching of Donor Cardiac and Renal Parenchyma

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Kidney allografts possess the ability to enable a short course of immunosuppression to induce tolerance of themselves and of cardiac allografts across a full-MHC barrier in miniature swine. However, the renal element(s) responsible for kidney-induced cardiac allograft tolerance (KICAT) are unknown. Here we investigated whether MHC disparities between parenchyma versus hematopoietic-derived “passenger” cells of the heart and kidney allografts affected KICAT. Heart and kidney allografts were co-transplanted into MHC-mismatched recipients treated with high-dose tacrolimus for 12 days. Group 1 animals (n = 3) received kidney and heart allografts fully MHC-mismatched to each other and to the recipient. Group 2 animals (n = 3) received kidney and heart allografts MHC-matched to each other but MHC-mismatched to the recipient. Group 3 animals (n = 3) received chimeric kidney allografts whose parenchyma was MHC-mismatched to the donor heart. Group 4 animals (n = 3) received chimeric kidney allografts whose passenger leukocytes were MHC-mismatched to the donor heart. Five of six heart allografts in Groups 1 and 3 rejected <40 days. In contrast, heart allografts in Groups 2 and 4 survived >150 days without rejection (p < 0.05). These data demonstrate that KICAT requires MHC-matching between kidney allograft parenchyma and heart allografts, suggesting that cells intrinsic to the kidney enable cardiac allograft tolerance.

basic (laboratory) research / science
heart transplantation / cardiology
kidney transplantation / nephrology
tolerance
tolerance: mechanisms

Abbreviations

ACR
acute cellular rejection
CAV
cardiac allograft vasculopathy
CML
cell-mediated lympholysis
CsA
cyclosporine
HSC
hematopoietic stem cell
KICAT
kidney-induced cardiac allograft tolerance
MHC
major histocompatibility complex
MLR
mixed lymphocyte reaction
PBMC
peripheral blood mononuclear cells
pDCs
plasmacytoid dendritic cells
POD
postoperative day
PSL
percent specific lysis
RTECs
renal tubular epithelial cells
VCA
vascularized composite allograft

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