• S M Pham, A S Rao, A Zeevi, K R McCurry, R J Keenan, J D Vega, R L Kormos, B G Hattler, J J Fung, T E Starzl, and B P Griffith.
• Department of Surgery, Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pennsylvania, USA. spham@exchange.med.miami.edu
• Ann. Thorac. Surg. 2000 Feb 1; 69 (2): 345-50.

BackgroundWe have demonstrated that donor cell chimerism is associated with a lower incidence of obliterative bronchiolitis (OB) in lung recipients, and that donor chimerism is augmented by the infusion of donor bone marrow (BM). We herein report the intermediate results of a trial combining the infusion of donor BM and lung transplantation.MethodsClinical and in vitro data of 26 lung recipients receiving concurrent infusion of donor bone marrow (3.0 to 6.0 x 10(8) cells/kg) were compared with those of 13 patients receiving lung transplant alone.ResultsPatient survival and freedom from acute rejection were similar between groups. Of the patients whose graft survived greater than 4 months, 5% (1 of 22) of BM and 33% (4 of 12) of control patients, developed histologic evidence of OB (p = 0.04). A higher proportion (but not statistically significant) of BM recipients (7 of 10, 70%) exhibited donor-specific hyporeactivity by mixed lymphocyte reaction assays as compared with the controls (2 of 7, 28%).ConclusionsInfusion of donor BM at the time of lung transplantation is safe, and is associated with recipients' immune modulation and a lower rate of obliterative bronchiolitis.

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