Article open access publication

Blood Chimerism in Dizygotic Monochorionic Twins During 5 Years Observation

American Journal of Transplantation, Wiley, ISSN 1600-6135

Volume 17, 10, 2017

DOI:10.1111/ajt.14318, Dimensions: pub.1084940844, PMID: 28422403,



  1. (1) Department of Clinical Immunology, Blood bank, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  2. (2) University of Copenhagen, grid.5254.6, KU
  3. (3) Department of Clinical Biochemistry, Nordsjællands Hospital Hillerød, Copenhagen University Hospital, Hillerød, Denmark
  4. (4) National University of Singapore, grid.4280.e
  5. (5) Department of Growth and Reproduction, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark








Dizygotic monochorionic twin pregnancies can result in blood chimerism due to in utero twin-to-twin exchange of stem cells. In this case, we examined the proportion of allogeneic red blood cells by flow cytometry and the proportion of allogeneic nucleated cells by digital polymerase chain reaction at 7 months and again at 5 years. We found an increase in the proportion of allogeneic cells from 63% to 89% in one twin, and a similar increase in autologous cells in the other twin from 57% to 84%. A paradigm for stem cell therapy could be modeled on this case: induction of tolerance and chimerism by antenatal transfusion of donor stem cells. The procedure would hold the promise of transplantation and tolerance induction without myeloablative conditioning for inheritable benign hematological diseases such as sickle cell disease and thalassemia.

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