Mesenchymal stem cells in the treatment of chronic active humoral rejection of kidney transplants: a pilot study
- Authors: Rapetskaya N.V.1, Komissarov K.S.1,2, Dmitrieva M.V.2, Nazarova E.A.1, Prymakova E.A.1, Dedyulya N.I.1, Symanovich A.A.1, Yurkina E.G.1, Romanova I.A.1, Krivenko S.I.1, Kalachyk O.V.1,2
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Affiliations:
- Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
- Belarusian State Medical University
- Issue: Vol 17, No 4 (2025)
- Pages: 20-26
- Section: Original Articles
- URL: https://journals.rcsi.science/2075-3594/article/view/375406
- DOI: https://doi.org/10.18565/nephrology.2025.4.20-26
- ID: 375406
Cite item
Abstract
Objective. Evaluation of the safety and efficacy of mesenchymal stem cells (MSCs) in the treatment of chronic active humoral kidney graft rejection (CAHKGR).
Materials and methods. A pilot study was conducted using mesenchymal stem cells (MSCs) in the treatment of morphologically verified CAHKGR in 7 kidney recipients.
Results. No statistically significant changes in creatinine levels, glomerular filtration rate (GFR), or proteinuria were observed after MSC treatment. The one-year graft survival rate was 100%. No deaths or serious complications from MSC therapy were recorded.
Conclusion. The use of MSCs is a promising approach in transplant nephrology due to its positive effect on the renal allograft, including stabilization of GFR, satisfactory tolerability of therapy, and minimal complications, which allows for increased graft survival.
About the authors
Nadzeya V. Rapetskaya
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Author for correspondence.
Email: n.rapetskaja@gmail.com
ORCID iD: 0009-0005-4560-1162
Nephrologist, Department of Transplant Nephrology
Belarus, MinskKirill S. Komissarov
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology; Belarusian State Medical University
Email: kirill_ka@tut.by
ORCID iD: 0000-0002-2648-0642
Cand.Sci. (Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation
Belarus, Minsk; MinskMargarita V. Dmitrieva
Belarusian State Medical University
Email: mvdmitieva@inbox.ru
ORCID iD: 0000-0002-2958-9424
Cand.Sci. (Med.), Associate Professor, Department of Pathological Anatomy
Belarus, MinskEkaterina A. Nazarova
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: k.nazarova-86@mail.ru
ORCID iD: 0000-0001-7147-4834
Cand.Sci. (Biology), Associate Professor, Clinical Laboratory Diagnostics Doctor, Laboratory of Cellular Biotechnology
Belarus, MinskEvgeniya A. Prymakova
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: gane_sel@mail.ru
ORCID iD: 0000-0002-3011-2287
Clinical Laboratory Diagnostics Doctor, Laboratory of Cellular Biotechnology
Belarus, MinskNatalya I. Dedyulya
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: nata_2010@tut.by
ORCID iD: 0000-0001-9807-2093
Cand.Sci. (Biology), Associate Professor, Head of the Laboratory of Cellular Biotechnology
Belarus, MinskAlla A. Symanovich
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: aleftyna@tut.by
ORCID iD: 0000-0003-1521-1620
Cand.Sci. (Biology), Clinical Laboratory Diagnostics Doctor, Laboratory of Cellular Biotechnology
Belarus, MinskEkaterina G. Yurkina
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: ekatherina999@mail.ru
ORCID iD: 0000-0002-0966-7456
Senior Researcher
Belarus, MinskIrina A. Romanova
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: romirina1978@gmail.com
ORCID iD: 0000-0001-6577-9738
Researcher
Belarus, MinskSvetlana I. Krivenko
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology
Email: svtl_kr@tut.by
ORCID iD: 0000-0002-6813-4465
Dr.Sci. (Med.), Professor, Deputy Director for Research
Belarus, MinskOleg V. Kalachyk
Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology; Belarusian State Medical University
Email: oleg_kalachik@hotmaill.com
ORCID iD: 0009-0002-6954-675X
Dr.Sci. (Med.), Professor, Deputy Director for Medical Affairs
Belarus, Minsk; MinskReferences
- Chehade H., Pascual M. The challenge of acute antibody-mediated rejection in kidney transplantation. Transplantation. 2016;100(2):264–5. doi: 10.1097/TP.0000000000000959.
- Einecke G., Reeve J., Gupta G. et al. Factors associated with kidney graft survival in pure antibody-mediated rejection at the time of indication biopsy: importance of parenchymal injury but not disease activity. Am. J. Transplant. 2021;21:1391–401. doi: 10.1111/ajt.16161.
- Рапецкая Н.В., Комиссаров К.С., Дмитриева М.В. и др. Морфологическая структура поздней дисфункции почечного трансплантата. Клиническая нефрология. 2024;16(4):12–6. [Rapetskaya N.V., Komissarov K.S., Dmitrieva M.V. et al. Morphological structure of late kidney transplant dysfunction. Clin. Nephrol. 2024;16(4):12–6 (In Russ.)] doi: 10.18565/nephrology.2024.4.12-16.
- Sellarés J., de Freitas D.G., Mengel M. et al. Understanding the causes of kidney transplant failure: the dominant role of antibody-mediated rejection and nonadherence. Am. J. Transplant. 2012;12:388–99. Doi: 10.1111/ j.1600-6143.2011.03840.x.
- Redfield R.R., Ellis T.M., Zhong W. et al. Current outcomes of chronic active antibody-mediated rejection — a large single center retrospective review using the updated Banff 2013 criteria. Hum. Immunol. 2016;77:346–52. doi: 10.1016/j.humimm.2016.01.018.
- Rostaing L.P.E., Böhmig G.A., Gibbons B., Taqi M.M. Post-transplant surveillance and management of chronic active antibody-mediated rejection in renal transplant patients in Europe. Transpl. Int. 2023;36:11381. doi: 10.3389/ti.2023.11381.
- Moreso F., Crespo M., Ruiz J.C. et al. Treatment of chronic antibody-mediated rejection with intravenous immunoglobulins and rituximab: a multicenter, prospective, randomized, double-blind clinical trial. Am. J. Transplant. 2018;18:927–35. Doi: 10.1111/ ajt.14520.
- Eskandary F., Regele H., Baumann L. et al. A randomized trial of bortezomib in late antibody-mediated kidney transplant rejection. J. Am. Soc. Nephrol. 2018;29:591–605. doi: 10.1681/ASN.2017070818.
- Kulkarni S., Kirkiles-Smith N.C., Deng Y.H. et al. Eculizumab therapy for chronic antibody-mediated injury in kidney transplant recipients: a pilot randomized controlled trial. Am. J. Transplant. 2017;17:682–91. doi: 10.1111/ajt.14001.
- Cheungpasitporn W., Kremers W.K., Lorenz E. et al. De novo donor-specific antibody following BK nephropathy: incidence and association with antibody-mediated rejection. Clin. Transplant. 2018;32:e13194. doi: 10.1111/ctr.13194.
- Федулов А.С., Борисов А.В., Зафранская М.М. и др. Патогенетическая терапия рассеянного склероза с использованием трансплантации мезенхимальных стволовых клеток: актуальное состояние, проблемы и перспективы развития технологии. Медицинские новости. 2018;(1):1–8. [Fedulov A.S., Borisov A.V., Zafranskaya M.M. et al. Pathogenetic therapy of multiple sclerosis using mesenchymal stem cell transplantation: current status, challenges, and prospects. Meditsinskie novosti. 2018;(1):1–8 (In Russ.)]. URL: https://cyberleninka.ru/article/n/ patogeneticheskaya-terapiya-rasseyannogo-skleroza-s-ispolzovaniem-transplantatsii-mezenhimalnyh-stvolovyh-kletok-aktualnoe.
- Stoma I., Karpov I., Krivenko S. et al. Mesenchymal stem cell transplantation in hematological patients with acute graft-versus-host disease: characteristics and risk factors for infectious complications. Ann. Hematol. 2018;97:885–91. doi: 10.1007/s00277-018-3250-8.
- Коротков С.В., Назарова Е.А., Юркина Е.Г. и др. Применение мезенхимальных стволовых клеток при трансплантации печени: оценка отдаленных результатов. Трансплантология. 2025;17(3):232–45. [Korotkov S.V., Nazarova E.A., Yurkina E.G., et al. Application of mesenchymal stem cells in liver transplantation: evaluation of long-term outcomes. Transplantology. 2025;17(3):232–45 (In Russ.)]. Doi: 10.23873/ 2074-0506-2025-17-3-232-245.
- Reinders M.E., Rabelink T.J., de Fijter J.W. The role of mesenchymal stromal cells in chronic transplant rejection after solid organ transplantation. Curr. Opin. Organ Transplant. 2013;18:44–50. doi: 10.1097/MOT.0b013e32835c2939.
- Bochon B., Kozubska M., Surygała G. et al. Mesenchymal stem cells: potential applications in kidney diseases. Int. J. Mol. Sci. 2019;20:2462. doi: 10.3390/ijms20102462.
- Tabera S., Pérez-Simón J.A., Díez-Campelo M. et al. Effect of mesenchymal stem cells on viability, proliferation, and differentiation of B-lymphocytes. Haematologica. 2008;93:1301–9. doi: 10.3324/haematol.12857.
- Podestà M.A., Remuzzi G., Casiraghi F. Mesenchymal stromal cell therapy in solid organ transplantation. Front. Immunol. 2021;11:618243. doi: 10.3389/fimmu.2020.618243.
- Casiraghi F., Remuzzi G. Mesenchymal stromal cells in kidney transplantation. Curr. Opin. Nephrol. Hypertens. 2019;28:40–6. doi: 10.1097/MNH.0000000000000461.
- Способ получения мезенхимальных стволовых клеток из жировой ткани человека: пат. BY 18051. [Method for obtaining mesenchymal stem cells from human adipose tissue: patent (In Russ.)]. URL: https://by.patents.su/ 6-18051-sposob-polucheniya-mezenhimalnyh-stvolovyh-kletok-iz-zhirovojj-tkani-cheloveka.html.
- Loupy A., Haas M., Roufosse C. et al. The Banff 2019 Kidney Meeting Report (I): updates on and clarification of criteria for T cell- and antibody-mediated rejection. Am. J. Transplant. 2020;20:2318–31. doi: 10.1111/ajt.15898.
- Haas M., Mirocha J., Huang E. et al. A Banff-based histologic chronicity index is associated with graft loss in patients with a kidney transplant and antibody-mediated rejection. Kidney Int. 2023;103:187–95. Doi: 10.1016/ j.kint.2022.09.030.
- Pöge U., Gerhardt T., Palmedo H. et al. MDRD equations for estimation of GFR in renal transplant recipients. Am. J. Transplant. 2005;5:1306–11. doi: 10.1111/j.1600-6143.2005.00861.x.
- Tan J., Wu W., Xu X. et al. Induction therapy with autologous mesenchymal stem cells in living-related kidney transplants: a randomized controlled trial. JAMA. 2012;307:1169–77. doi: 10.1001/jama.2012.316.
- Reinders M.E., de Fijter J.W., Roelofs H. et al. Autologous bone marrow-derived mesenchymal stromal cells for treatment of allograft rejection after renal transplantation: results of a phase I study. Stem Cells Transl. Med. 2013;2:107–11. doi: 10.5966/sctm.2012-0114.
- Fan L., Hu C., Chen J. et al. Interaction between mesenchymal stem cells and B-cells. Int. J. Mol. Sci. 2016;17:650. doi: 10.3390/ijms17050650.
- Wei Y., Chen X., Zhang H. et al. Efficacy and safety of bone marrow-derived mesenchymal stem cells for chronic antibody-mediated rejection after kidney transplantation: a single-arm, two-dosing-regimen, phase I/II study. Front. Immunol. 2021;12:662441. doi: 10.3389/fimmu.2021.662441.
- Park H., Fang X., Lee H. et al. Clinical trial assessing the safety and efficacy of human bone marrow-derived allogeneic mesenchymal stem cell therapy for chronic active antibody-mediated rejection in kidney transplant recipients. Cytotherapy. 2025;27:1199–207. doi: 10.1016/j.jcyt.2025.05.011.
- Večerić-Haler Ž., Sever M., Kojc N. et al. Autologous mesenchymal stem cells for treatment of chronic active antibody-mediated kidney graft rejection: report of the phase I/II clinical trial case series. Transpl. Int. 2022;35:10772. doi: 10.3389/ti.2022.10772.
- Hao T., Chen J., Zhi S. et al. Comparison of bone marrow- vs adipose tissue-derived mesenchymal stem cells for attenuating liver fibrosis. Exp. Ther. Med. 2017;14:5956–64. doi: 10.3892/etm.2017.5333.
- Yoshida M., Nakashima A., Ishiuchi N. et al. Comparison of the therapeutic effects of adipose- and bone marrow-derived mesenchymal stem cells on renal fibrosis. Int. J. Mol. Sci. 2023;24:16920. doi: 10.3390/ijms242316920.
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