An end to Drugs After Organ Transplant?

Stem cells may save kidney transplant recipients from taking medications the rest of their lives

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A kidney transplant can save a person's life. But people with a transplanted kidney often have to take anti-rejection drugs for much of their lives. A new discovery may make these drugs unnecessary for some.

New stem cell research suggests that kidney transplant recipients soon may no longer need to take anti-rejection drugs. Using donor stem cells, scientists can 'trick' recipients' immune systems into thinking the transplanted kidney is part of the patient's natural body.

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According to study author Joseph Leventhal, M.D., Ph.D., a transplant surgeon at Northwestern Memorial Hospital, the initial findings from this study are exciting and could change the future of organ transplantation.

"Being a transplant recipient is not easy," says Suzanne Ildstad, M.D., co-author of the study from the University of Louisville.

"In order to prevent rejection, current transplant recipients must take multiple pills a day for the rest of their lives," Dr. Ildstad explains. "These immunosuppressive medications come with serious side effects with prolonged use including high blood pressure, diabetes, infection, heart disease and cancer, as well as direct damaging effects to the organ transplant.

"This new approach would potentially offer a better quality of life and fewer health risks for transplant recipients," she says.

At the moment, this method of using stem cells has only been tested on kidney transplant patients. Dr. Leventhal explains, however, "With refinement, this approach may prove to be applicable to the majority of patients receiving the full spectrum of solid organ transplants."

In the effort to make kidney transplants successful, doctors must make sure that donors and recipients are compatible. That is, donor and recipient should be related and have similar immune system structures.

In the past, studies on stem cell transplants for organ recipients have looked at these matched donors and recipients. However, this new study did not require donor and recipient to be related or matched immunologically.

For this study, organ donors were asked not only to give a kidney, but also to give up part of their immune system to eight kidney patients.

About a month before transplant surgery, bone marrow stem cells are taken from the kidney donor. Scientists - who, for now, are located at the University of Louisville - then give a boost to those cells that are believed to improve the success of transplants.

At the same time, doctors prepare the kidney recipients body to receive the new cells. Radiation and chemotherapy is used to open up room for the donor's stem cells.

On the day after kidney transplant surgery, the kidney recipient is given the donor stem cells, which trigger other stem cells to form in bone marrow. These cells then become other specialized blood cells, such as immune cells.

The aim of this process is to make a situation in which two bone marrow systems can exist and work in the same person.

After organ and stem cell transplant, the kidney recipient still must take anti-rejection drugs. However, the eventual goal is to stop drug treatment within a year by gradually lowering the dosage.

"This is something I have worked for my entire life," says Dr. Ildstad.

This clinical trial is still in progress. This initial findings are published in the journal Science Translational Medicine.

The researchers plan to test a similar treatment for patients who have already received a kidney transplant from a living donor. 

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Review Date: 
March 7, 2012
Last Updated:
March 7, 2012