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Might kidney-transplant recipients be able to toss their pills?

Up to 30 per day. That's how many pills a typical kidney-transplant recipient can expect to have to ingest every day for the rest of his or her life. Not that it's not worth swallowing them - the life expectancy of someone receiving an immunologically matched kidney from a living donor is 25 to 30 years, double the life expectancy for a patient who remains on dialysis instead of getting a kidney tranplant.

Still, even the best of immunological matches, unless the donor is your identical twin, will leave your immune system scratching away at the new organ until, over time, it weakens and fails. This erosion can be vastly slowed by keeping your immune system in a constant state of suppression, via a stiff daily regimen of drugs that do just that.

But a medical advance developed by Stanford's Sam Strober, MD, appears to be allowing kidney-transplant patients to get weaned off of these drugs. In a letter to the New England Journal of Medicine, Strober, nephrologist John Scandling, MD, and other Stanford researchers  describe a new post-transplant protocol involving radiation treatment and injections of blood-forming stem cells from the donor as well as antibodies targeting the recipient's own immune system. As my release states:

Eight of the 12 patients discussed in the small study have now been off of immunosuppressant drugs for at least one year, and in some cases for longer than three years, without any apparent damage to their new kidney — unheard-of in patients undergoing standard transplantation procedures. None of the 12 patients has experienced kidney transplant failure or serious side effects.

The new brew seems to suppress the kidney receiver's immune system long enough for the donor's stem cells to differentiate into a complementary set of immune cells, with a resulting balance between donor and recipient immune systems.

It took more than 30 years of mouse research on Strober's part to get just the right mix of ingredients to achieve this balance, he says. But it has finally started paying off for us people.

The study is actively recruiting new subjects and is now being expanded to include less-than-perfectly matched donor/recipient pairs. Patients considering enrolling can learn more about it by contacting the study coordinator, Asha Shori.

Photo by psyberartist

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