Kidney transplant patients seek life without drugs with experimental immune system procedure
Transplanting some of the kidney donor's immune-producing cells along with the new organ March 8, 2012
Lindsay Porter's kidneys were failing rapidly when a friend offered to donate one of his. Then she made an unusual request: Would he donate part of his immune system, too?
Every day for the rest of their lives, transplant recipients must swallow handfuls of pills to keep their bodies from rejecting a donated organ. The Chicago woman hoped to avoid those problematic drugs, enrolling in a study to try to trick her own immune system into accepting a foreign kidney.
It's one of a series of small, high-stakes experiments around the country that has researchers hopeful that they're finally closing in on how to help at least some transplant patients go drug-free. The key: Create a sort of twin immunity, by transplanting some of the kidney donor's immune-producing cells along with the new organ.
"I'm so lucky," says the 47-year-old Porter, who stumbled across the research at Chicago's Northwestern University. Porter was able to quit her pills last summer, a year after her transplant, and says, "I feel amazing."
These experiments are a big gamble. If the technique fails, patients could lose their new kidney, possibly their lives. Doctors stress that no one should try quitting anti-rejection drugs on their own.
Why risk it even in a careful scientific study? Anti-rejection medications can cause debilitating, even deadly, side effects, from fatigue and infections to an increased risk of cancer and kidney damage.
Without the drugs, "the hope for me is I'm able to keep this kidney for the rest of my life," Porter says.
Across the country, Stanford University is testing a slightly different transplant method - and hosted a reunion earlier this month for about a dozen kidney recipients who've been drug-free for up to three years.
"These people who are off their drugs, they're cured," says Dr. Samuel Strober, who leads the study of Stanford's approach. "If they have to be on drugs the rest of their life, it doesn't have the same meaning of `cure.'"
Anti-rejection drugs work by ratcheting down the immune system, suppressing it from attacking foreign cells. For decades, scientists have sought ways to eliminate the need for the drugs by inducing what's called tolerance - getting one person's immune system to live in harmony with another person's tissue.
The experimental approach: Transplant the seeds of a new immune system along with a new kidney. It's the 21st-century version of a bone marrow transplant, and possible for now only if the transplanted kidney comes from a living donor.
FACTS ABOUT ORGAN DONATION:
104,748 U.S. patients are currently waiting for an organ transplant; more than 4,000 new patients are added to the waiting list each month.
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FACTS ABOUT ORGAN TRANSPLANTATION:
The Need Is Real: Data During your visit to organdonor.gov someone may have been added to the waiting list. It happens every 11 minutes. Each day, an average of 75 people receive organ transplants. However, an average of 20 people die each day waiting for transplants that can't take place because of the shortage of donated organs. Organ transplantation has become an accepted medical treatment for end-stage organ failure. The facts prove it. But only you can help make it happen. Statistics can sometimes be overwhelming and difficult to understand. One thing to remember is that every number in the statistic you view is a person, a person who either needs your help and is waiting for a lifesaving transplant or a person who has left a lasting legacy through organ and tissue donation. Either way each number represents a life, a mom, a dad, a brother, a sister or a child, someone who is important to someone else, maybe even you. Statistics change. Some change day to day and some can even change minute to minute. So you may see different numbers each time you return to organdonor.gov or some of the other sites linked from here. You may ask why this happens. There are several reasons. One of the most confusing statistics is the number of persons waiting for a transplant. Patients are allowed to register at multiple transplant centers so you may see a higher number if you count "registrations" rather than "candidates." Additionally, one of the great things that may happen is that donations and transplantations may be taking place at any time, so while the waiting list might continue to grow the number of donors may also rise. The reality is that the number of candidates waiting continues to dwarf the number of donor organs available, and only you can change this. Here are some interesting facts:
> More about organ donation among minorities > Statistics & facts for people over 50 The Gap Continues to Widen Right now, there are more than enough people waiting for an organ to fill a large football stadium twice over. Data from optn.transplant.hrsa.gov and OPTN/SRTR Annual Report. ** Data include deceased and living donors. [ Graph description of Gap Continues to Widen ] |