WEDNESDAY, March 7 (HealthDay News) -- Researchers report that
they were able to create a kind of hybrid immune system in patients
who received kidney transplants, a process that appeared to allow
the recipients' bodies to accept a foreign organ instead of trying
to reject it.
There are caveats. The research is preliminary and only involved
a tiny number of patients. Also, the required procedure is
expensive and its long-term effects aren't known.
But if it works, the process -- which involves transferring bone
marrow cells from the kidney donor to the patient -- could allow
organ transplant recipients to avoid a lifetime of taking dozens of
pills a day. "It's a huge step forward," said Dr. Suzanne Ildstad,
director of the University of Louisville's Institute for Cellular
Therapeutics, and co-author of the study published in the March 7
issue of
Science Translational Medicine.
The immune system's job is to keep invaders out of the body, but
it can do its work too well when a patient needs an organ
transplant. "People think that once you get your transplant,
everything is simple, but it's really far from that," Ildstad
said.
Patients often have to take 15 to 25 pills a day to dampen their
immune system, she said, and that can lead to complications such as
infections, diabetes, high blood pressure and cancer.
"Even if you're perfect and take your drugs every day, every year there's a certain number of transplants lost to chronic rejection," Ildstad explained.
One way to get the immune system under control is to make it
think like the immune system in the person who's donating the
organ. That immune system of the donor would recognize the
transplanted organ and not try to get rid of it.
In the new procedure, the researchers removed stem cells from
the bone marrow of the kidney donors, put them through a special
process designed to give them a boost, then inserted them into the
organ recipients.
Essentially, the goal is to create a hybrid immune system --
part donor, part recipient -- in the bone marrow of the recipient.
The marrow then creates cells in the immune system.
Of eight patients, five have not required any medications to
suppress their immune systems, Ildstad said. Two of the patients
take the medications at a low dose; one patient experienced
complications related to blood poisoning and a blood clot in an
artery to the kidneys.
The extra cost per patient beyond the expense of the transplant
is about $50,000, Ildstad said. The next step is to determine
whether the procedure would work for other kinds of transplants,
she said.
Ildstad has a financial interest in Regenerex LLC, a company
that participated in the study.
Dr. Tatsuo Kawai, a transplant specialist and associate
professor of surgery at Harvard Medical School, said the findings
are a "big deal." However, the safety of the procedure still needs
to be confirmed, and it remains "highly risky" for the moment, said
Kawai, who co-wrote a commentary accompanying the study.
In the commentary, Kawai noted some study weaknesses. Beside its
small size, the study lacked a control group of patients who did
not receive the new procedure, to allow comparisons. Also, he wrote
that it might be difficult for other researchers to validate the
findings, as the study doesn't fully disclose manufacturing details
of the new process.
More information
For more about
organ transplants, visit the U.S. National Library of Medicine.