Immunosuppression is required in patients for allograft survival after kidney transplantation throughout life. However, it may not be able to prevent allograft loss resulting from chronic rejection. An approach was developed that aimed to nullify immune rejection and the need for post-transplantation immunosuppression in patients with Schimke immune-osseous dysplasia with T-cell immunodeficiency and renal failure. 

In a study, where patients received sequential transplants of αβ T-cell–depleted and CD19 B-cell–depleted haploidentical hematopoietic stem cells and a kidney from the same donor, they continued to have normal renal function without immunosuppression at 22-34 months after kidney transplantation. 

Reference: Bertaina A, Grimm PC, Weinberg K, Parkman R, et al. Sequential stem-cell kidney transplantation in Schimke immune-osseous dysplasia. N Engl J Med. 2022; 386: 2295-2302.