Revolutionary technique could reduce lifelong drugs for transplant patients

Aug 05, 2008

Researchers have developed a ground-breaking procedure that could avoid the need for transplant patients to spend the rest of their lives taking a cocktail of drugs to stop their system from rejecting their new organ, according to a series of papers in the August issue of Transplant International.

The team, led by Professor Fred Fandrich from the University of Schleswig-Holstein in Kiel, Germany, has developed a technique based on tailor-made regulatory cells.

This involves taking infection-fighting white cells from the blood of the transplant recipient and subjecting them to a highly complex procedure involving cells taken from the living or deceased donor. The tailor-made cells are then administered back to the patient.

In the two clinical trials described in Transplant International this was done in two ways, either after the transplant, as an addition to the traditional drug therapy to stop the patient's immune system rejecting the kidney, or before the transplant surgery was carried out.

"Until now the only option for transplant patients has been to take a cocktail of drugs for the rest of their lives" explains lead author Dr James A Hutchinson from the University's Division of Transplantation Medicine and Biotechnology.

"These drugs can cause severe side effects and cannot always prevent the slow destructive process of chronic rejection which often leads to the failure of the transplanted organ.

"That is why our use of transplant acceptance-inducing cells (TAICs) in kidney transplant patients is such an exciting development, as it could eventually offer patients who have had transplant surgery a much higher quality of life, free from complex drug regimes.

"Although our use of TAICs is still in the preliminary stages, the results of our clinical trials on 17 kidney transplant patients are promising."

During stage one of the clinical trials 12 patients received kidneys from deceased donors and were give the TAICs in addition to the traditional drug therapy used to prevent organ rejection. Nine men and three women aged between 30 and 61 took part in the trial.

Ten of the 12 patients were weaned off conventional immunosupression drugs over a period of eight weeks, starting in the fourth week after transplantation. Medical staff were then able to wean six of them down to low-dose tacrolimus monotherapy, which is a much less intrusive drug regime with fewer side effects.

"We concluded that although the stage one trial showed that TAIC therapy was both safe and clinically practicable, the trial was unable to provide evidence that postoperative TAIC administration has a beneficial effect" says Dr Hutchinson.

Stage two comprised five patients who were transplanted with kidneys from live donors and received TAICs before their surgery was carried out.

Four men and one woman aged between 39 and 59 took part in the trial. Two received a kidney from their brother, one from his daughter and two from a spouse.

One patient was able to go eight months without any immunosuppression drugs and a further three were successfully weaned from a conventional immunosuppression regime to low-dose tacrolimus monotherapy.

"Although our stage two clinical trial did not provide conclusive evidence of a beneficial effect of pre-operative TAICs treatment, the results were encouraging" says Dr Hutchinson.

"They suggest that TAICs promote a physical state that might allow us to minimise the drugs we use to stop the patient's immune system from rejecting their new organ."

None of the patients in either trial experienced acute or delayed adverse events as the result of the TAIC infusion.

"Our research clearly shows that infusing TAICs into patients before they have a kidney transplant, or after the procedure has been carried out, is a practical and safe clinical option.

"Although this procedure is still being developed and refined, it poses an exciting possibility for clinicians and patients alike."

Source: Wiley

Explore further: Unprecedented germ diversity found in remote Amazonian tribe

Related Stories

United States, China team explore energy harvesting

3 hours ago

Six authors have described their work in harvesting energy in a paper titled "Ultrathin, Rollable, Paper-Based Triboelectric Nanogenerator for Acoustic Energy Harvesting and Self-Powered Sound Recording." ...

China's struggle for water security

4 hours ago

Way back in 1999, before he became China's prime minister, Wen Jiabao warned that water scarcity posed one of the greatest threats to the "survival of the nation".

Canada revises upward CO2 emission data since 1990

4 hours ago

Canada revised its greenhouse gas emission data from 1990 to 2013 in a report Friday, showing it had higher carbon dioxide discharges each year, and a doubling of emissions from its oil sands.

Fish found in suspected tsunami debris boat quarantined

14 hours ago

The wreckage of a fishing boat that appears to be debris from the 2011 Japanese tsunami was carrying some unexpected passengers—fish from Japanese waters—when it was spotted off the Oregon coast.

Recommended for you

Bacteria play only a minor role stomach ulcers in cattle

21 hours ago

Scientists at the University of Veterinary Medicine Vienna investigated whether stomach ulcers in cattle are related to the presence of certain bacteria. For their study, they analysed bacteria present in ...

New research reveals how our skeleton is a lot like our brain

Apr 17, 2015

Researchers from Monash University and St Vincent's Institute of Medical Research in Melbourne have used mathematical modelling combined with advanced imaging technology to calculate, for the first time, the number and connectivity ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.