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In summary, we have reported a case in which immune tolerance was successfully induced by the development of mixed chimerism using combined HSCT and KT. However, the mixed chimerism and immune tolerance were not durable, and the patient returned to maintenance immunosuppression 137 days after discontinuation of the initial immunosuppression therapy. This case suggests that future studies should focus on the development of an effective induction protocol for more stable immune tolerance and monitoring methods to accurately measure immune tolerance.