Donor-Type Microchimerism Associated with Graft Rejection Eight Years after Liver Transplantation

To the Editor: Transplantation of solid-organ allografts can induce long-term donor-type microchimerism1 by migration of passenger mononuclear cells2,3. So far, microchimerism has been described only in immunologically stable patients after liver or kidney transplantation4. An association between persistent chimerism and graft acceptance has been suggested. We describe persistent donor-type microchimerism in a patient with therapy-resistant graft rejection late after liver transplantation. In December 1984 a 17-year-old boy (HLA-A1,11; B7,8; Cw7; DRw15,w17) received a liver transplant (Donor 1: HLA-A1,25; B18,w52; DR1,4) for end-stage primary sclerosing cholangitis. After an early episode of rejection that responded to steroids, he had . . .