Mixed chimerism to induce tolerance: lessons learned from nonhuman primates

The mixed chimerism approach has been demonstrated to be an effective means of inducing allograft tolerance. Based on our rodent studies on mixed chimerism, we previously developed a clinically relevant nonmyeloablative preparative regimen that permits the induction of mixed chimerism and renal allograft tolerance following donor bone marrow transplantation in major histocompatibility complex fully mismatched cynomolgus monkeys. This approach has been successfully extended to HLA matched or mismatched kidney transplant recipients. In the manuscript, we summarize some of the important conclusions made in our laboratories regarding induction of mixed chimerism and allograft tolerance in a nonhuman primate model.