Transplant Procedure Creates ‘Hybrid’ Immune System to Combat Rejection

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.

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