Thymus transplantation.

Abstract

Thymus transplantation is a promising investigational therapy for infants born with no thymus. Because of the athymia, these infants lack T cell development and have a severe primary immunodeficiency. Although thymic hypoplasia or aplasia is characteristic of DiGeorge anomaly, in "complete" DiGeorge anomaly, there is no detectable thymus as determined by the absence of naive (CD45RA(+), CD62L(+)) T cells. Transplantation of postnatal allogeneic cultured thymus tissue was performed in sixty subjects with complete DiGeorge anomaly who were under the age of 2 years. Recipient survival was over 70%. Naive T cells developed 3-5 months after transplantation. The graft recipients were able to discontinue antibiotic prophylaxis, and immunoglobulin replacement. Immunosuppression was used in a subset of subjects but was discontinued when naive T cells developed. The adverse events have been acceptable with thyroid disease being the most common. Research continues on mechanisms underlying immune reconstitution after thymus transplantation.

• Authors: M Louise Markert, Blythe H Devlin, Elizabeth A McCarthy
• Journal: Clinical immunology (Orlando, Fla.) (Clin Immunol) Vol. 135 Issue 2 Pg. 236-46 (May 2010) ISSN: 1521-7035 [Electronic] United States
• PMID: 20236866 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Topics

• Cell Count
• DiGeorge Syndrome (immunology, surgery)
• Humans
• Infant
• T-Lymphocytes (immunology, transplantation)
• Thymus Gland (immunology, transplantation)
• Transplantation, Homologous (adverse effects, immunology, methods)
• Treatment Outcome