Organ transplant breakthrough
People with donated organs could one day be drug-free, scientists say
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Thursday, 24, Jan 2008 10:50
A successful case of an organ donor recipient living without immunosuppressive drugs has provided hope more patients could live drug-free for life.
Doctors treating 50-year-old Larry Kowalski reduced his use of drugs that prevent the body from rejecting a donor organ after they performed a new technique developed in mice.
Transplant recipients are matched as closely as possible with the donor organs to minimise the chance the body will reject the organ.
Without drugs to prevent the rejection - known as immunosuppressive drugs - the recipient's immune system attacks the organ and eventually destroys its function.
Long term use of the drugs has been linked to cancer, kidney damage and other side effects.
Mr Kowalski received his brother's kidney in 2005 and then underwent treatment to his immune system.
Scientists at the Stanford University school of medicine adjusted Mr Kowalski's immune system and then gave him an infusion of his brother's blood. This procedure boosts levels of immune T cells that can avert the attack that cause organ rejection.
His use of immunosuppressive drugs was tapered and after six months he went completely drug-free, which he has been able to sustain since then.
"Essentially, my immune system contains half my brother's immune cells and half of my own," said Mr Kowalski. "It's enough that my body thinks my brother's kidney is mine."
Dr Samuel Strober, who developed the technique over the past 25 years, commented: "It's been a long, long road that ends up with clinical trials that could lead to somebody's benefit.
"Tolerance has been the goal for decades, and we are just now beginning to see the fruits of all that labour."
However, the researchers note that six other patients treated like Mr Kowalski have not been able to come off their drugs, although their kidneys came from donors not so perfectly matched.
"The idea of getting off drugs holds tremendous appeal for patients," said the study's lead author Dr John Scandling.
"So far, there is hope, but we still have a long way to go."