Donor bone marrow cell infusion (Pittsburgh Protocol)

Donor bone marrow cell infusion is a cell-based immunomodulatory therapy developed as part of the Pittsburgh Protocol (also known as the Starzl Protocol) for vascularized composite allotransplantation (VCA). This therapy, a collaboration between Johns Hopkins University and the University of Pittsburgh, involves harvesting bone marrow cells from a deceased donor and infusing them into the recipient approximately 10 days after an upper extremity transplant (e.g., hand or arm). The procedure follows initial T-cell depletion, typically with alemtuzumab. The primary goal of the bone marrow infusion is to induce donor-specific immune tolerance by promoting the exhaustion and deletion of host anti-donor lymphocyte clones. This immunomodulatory effect aims to shift the risk-benefit ratio of reconstructive transplantation by allowing patients to maintain graft survival on low-dose tacrolimus monotherapy, thereby avoiding the significant morbidity associated with conventional high-dose, multi-drug immunosuppressive regimens.

Other names

Donor bone marrow cell-based therapyDonor bone marrow cell infusionBone marrow cell-based therapy-Johns Hopkins University