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. 2021 Jul;9(13):1070. doi: 10.21037/atm-21-313

Figure 1.

Figure 1

Delayed tolerance induction protocol for VCA. The sequence and timing of the protocol interventions are depicted relative to the timing of VCA and DBMT. The VCAs were maintained with conventional triple-drug immunosuppression for 60 days, followed by DBMT using a nonmyeloablative conditioning regimen including total body irradiation (TBI, 150 cGy, on POD 54 and 55), thymic irradiation (TI, 700 cGy on POD 59), ATGAM (IV 50 mg/kg on POD 58, 59 and 60), methylprednisolone (IV 5 mg on POD 58, 59 and 60) and anti-CD8 mAb (cM-T807, Centocor, Inc., Horsham, PA; 5 mg/kg IV on POD 59). After DBMT, the recipients were treated with short courses of anti-CD40L (h5C8; 20 mg/kg IV on POD 60 and 62, and 10 mg/kg on POD 65, 67, 69, and 72) and anti-IL-6 receptor mAb (tocilizumab, ACTEMRA®; Genentech, San Francisco, CA; 10 mg/kg IV on POD 0, 67, 74, 81 and 88). After this, no further immunosuppression was given. ATGAM, equine anti-thymocyte globulin; DBMT, delayed bone marrow transplantation; mAb, monoclonal antibody; POD, post-operative day; TBI, total body irradiation; TI, thymic irradiation; VCA, vascularized composite allograft.