Researchers from the Stanford School of Medicine gathered with patients Sunday to celebrate a successful clinical trial that tested an alternative to the immunosuppressant drug regimen that patients must normally follow after a transplant procedure.
“If one were able to make to make every transplantation a reality in the 20th century, the goal for the 21st century should be to do it without drugs,” said Samuel Strober, an associate professor in the immunology and rheumatology department.
Traditionally, patients who receive transplants must take immunosuppressant drugs to prevent their own immune systems from attacking the new organ because the immune system recognizes it as foreign.
In order to prevent the transplant recipient’s body from attacking the new organ without a drug regimen, the researchers suppressed each patient’s immune system via radiation therapy and then introduced some of the donor’s immune cells into the recipient’s immune system via the thymus and peripheral lymphoid tissue. Introducing immune cells from the donor prevented the recipient’s immune system from recognizing the transplanted organ’s cells as foreign and attacking the tissue.
This alternative, which worked in 12 of 15 kidney transplant patients who participated in the trial, would eliminate the potential to contract drug-induced toxicity that can result from taking the immunosuppressant drugs. It would also eliminate the cost of the immunosuppressant drugs for patients, which can run anywhere from $20,000 to $120,000 over a patient’s lifetime.
Patients on the traditional immunosuppressant regimen may experience negative side effects, such as increased susceptibility to infection. Some ultimately reject their donated organ.
“In patients using drugs nowadays, half of transplants will be lost over a couple of months,” Strober said.
One of the study participants, John Every, former vice president of the University of Pacific and an early participant in the trial, received his kidney transplant 11 years ago on his birthday, what he refers to as the “best birthday present.” Although Every eventually had to return to a lower dosage of one of his previous drugs, he said he is grateful for how the team’s research improved his quality of life.
Likewise, Karen Burke, who received her kidney transplant in 2006, also benefited from the grant funded by the National Institutes of Health, without which she said she could not have afforded her treatment. As her kidneys declined to 12 percent of their full functionality, she met with her nephrologist John Scandling, director of kidney and pancreas transplantation at the School of Medicine, who recommended she undergo an organ transplant. Since the trial, Burke has remained off immunosuppressant drugs and lives in Modesto with her two daughters.
“What’s the best drug? No drug,” said Stephan Busque, director of the adult kidney and pancreas transplant program at the School of Medicine.