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Minerva Chirurgica 2006 April;61(2):85-94


language: Italian

Immunomodulation after combined spleen and kidney transplantation in swine

Rademacher J. 1, 2, Cansolino L. 2, Crespi S. 1, Lenti L. M. 1, Lillo E. 1, Tubazio I. 1, Oldani O. 1, Passalia L. 2, Maestri M. 2, 3, Gaspari A. 1, Dionigi P. 2, 3

1 Università degli Studi di Pavia 2 Dipartimento di Scienze Chirurgiche Rianimatorie, Riabilitative e dei Trapianti d’organo Laboratorio di Chirurgia Sperimentale, Pavia 3 Istituto di Chirurgia Epatopancreatica IRCCS Policlinico S. Matteo, Pavia


Aim. Organ transplantation is the most effective treatment for several degenerative end-stage diseases. While the mainstream immunosuppression can achieve satisfactory results, the therapy has either side effects and flaws. The golden target to reach should be a stable tolerance with the transplanted organ accepted without a long term drug administration. Recent studies demonstrated a tolerogenic effect of spleen cells. Aim of this study is to evaluate a model of combined spleen and whole organ transplantation in a significant preclinical setting in swine.
Methods. Twenty-five outbred Landrace/Large-White swine underwent combined spleen/kidney transplantation (SKTx). The experiments were stratified into 3 groups per randomization. Group 1 (N=7) received kidney transplantation (KTx) alone with no immunosuppressive treatment. Group 2 (N=9) had a combined KTx and whole graft spleen Tx. Group 3 (N=9) had KTx and spleen cells (DST), injected through the portal vein. Renal lab tests were collected to evaluate the onset of rejection. Survivals were evaluated as well. The end-point of the study was at onset of kidney failure or at the limit of 60 postoperative day (POD) in non-rejecting animals. Tissue samples were collected to evaluate grade and severity of rejection.
Results. Controls died from kidney failure within 10th POD. Group 2 and 3, had a delayed renal graft rejection and an overall prolonged graft survival. Whole graft and spleen cells injection share this effect, while spleen administration through the portal route proved a superior effect, which is significant compared to controls (Kaplan Meier survival analysis P<0.05).
Conclusion. These results, from a non immunosuppressed setting, suggest that spleen plays a key role as an immunomodulatory organ.

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