Three children with a rare genetic disease required kidney transplants, and using a unique transplant technique, doctors successfully replaced the children’s kidneys without the need for immunosuppressive drugs.
Typically, after a transplant, organ recipients must take immunosuppressive drugs for the rest of their lives to prevent it immune system of organ rejection. This puts organ recipients at increased risk of infection and cancer, and even then, immunosuppressive drugs don’t eliminate the risk that the body will eventually reject the organ anyway.
To reduce or eliminate the need for immunosuppression, physicians have attempted to transplant stem cells from the organ donor’s bone marrow into the recipient along with their new organ, a expression. These bone marrow-derived stem cells mature into various types of blood cells, including types of immune cells called lymphocytes, which mark foreign substances in the body. In theory, since these stem cells come from the donor, the transplant recipient’s body would recognize the newly transplanted organ as familiar, thus reducing the risk of rejection. Unfortunately, such stem cell transplants carry a major risk: a condition called graft-versus-host disease, in which the new immune cells accidentally attack the transplant recipient’s body from the inside.
Now Stanford doctors have developed a new approach to transplanting kidneys and stem cells into patients, and so far none of the three patients who underwent the procedure have reported severe graft-versus-host disease or need long-term immunosuppression the team on Wednesday (June 15) in the New England Journal of Medicine.
Related: Man who received first pig heart transplant has died
“This is groundbreaking,” said Dr. Amit Tevar, surgical director of the Kidney and Pancreas Transplant Program at the University of Pittsburgh Medical Center, who was not involved in the research, said NBC News.
The transplant recipients included 8-year-old Kruz Davenport and his 7-year-old sister Paizlee, and another child with a rare immune disorder called Schimke’s immunoosseous dysplasia (SIOD). This condition is characterized by chronic kidney disease requiring kidney transplantation and causing bone marrow failure requiring stem cell transplantation. Of the three children in the new study, one parent became both a stem cell and kidney donor for their child. First, the doctors performed the stem cell transplant. Then, five to ten months later, after the child had recovered from that transplant, the doctors transplanted that child’s kidney from the same parent.
The three patients have now been living with their new, fully functional kidneys for 22 to 34 months. “They do everything: they go to school, they go on vacation, they play sports,” said Dr. Alice Bertaina, associate professor of pediatrics at Stanford and lead author of the study, in the statement. “They lead a completely normal life.”
Aside from not requiring immunosuppressive medication, all three children live without SIOD.
“They are walking wonders,” said Kruz and Paizlee’s mother, Jessica Davenport. “It’s really cool that they pave the way for other families to experience the same things that we’ve been able to experience.”
The technique, which researchers have dubbed DISOT for dual immune/solid organ transplantation, received FDA approval on May 27 to treat patients with certain diseases that affect the kidneys. The team expects the protocol to be approved as a treatment option for many others who need kidney transplants in the future. They also plan to explore using an adaptation of DISOT for other solid organ transplants.
Originally published on Live Science.
https://www.livescience.com/kidney-transplants-no-immunosuppression 3 kids receive kidney transplants without need for immune-suppressing drugs