- Researchers have found a safe way to give donated kidneys to children without the need for immunosuppressive drugs.
- An advance that they hope to expand to many more kidney transplant patients in the coming years.
- The researchers also hope to optimize the protocol, which includes incorporating transplants from deceased donors.
Researchers have found a safe way donate kidney to children without need immunosuppressant drugsAn advance that they hope to expand to many more kidney transplant patients in the coming years.
In a report in the June 15 edition of New England Journal of MedicineStanford University physicians describe The first three children were treated with the new approach. This involved giving him not only a new kidney, but also a new immune system, both donated by one of the parents.
now three kids have normal kidney function and are free of anti-rejection drugs that transplant recipientss should generally be taken every day for the rest of your life.
Much research remains to be done before the approach is widely offered, and experts warn that all three children in these cases had a rare genetic condition that caused their kidney disease.
“It’s a good outcome for these kids,” said Dr., director of pediatric nephrology at Children’s Mercy Kansas City in Missouri. Bradley Wardy said. “But we can’t extrapolate this to all the kids who need a kidney transplant.”
it became a warning “There is cautious optimism that this may become a more comprehensive process”Wardy, who is also on the board of directors of the National Kidney Foundation.
Lead researcher Dr. Elise Bertena said the findings suggest that the “holy grail” of transplant medicine can be achieved.
“Most importantly, we’ve shown it’s possible,” said Bertena, an associate professor of pediatrics at Stanford.
Both doctors said weaning kidney transplant recipients from anti-rejection drugs would be a big step. TookLifelong immune suppression has many consequencesThat includes an increased risk of serious infections and cancer, as well as conditions such as diabetes and high blood pressure.
The benefit of negating the need for anti-rejection drugs
Another note by Dr. Eliza Blanchett, a pediatrician at Children’s Hospital Colorado Benefits of negating the need for anti-rejection drugs: Over time, they can actually damage the kidneys they are designed to protect. It is therefore possible that drug-free patients will prolong the life of the donor kidney.
For years, researchers have found a way to inspire immune tolerancefor donor organs, so that lifelong anti-rejection drugs are unnecessary. One approach is through organ donor stem cell transplantation.
Stem cells are primitive cells that give rise to mature cells, including the immune system. then a stem cell transplant The organ donor essentially provides the recipient with a new immune system that must recognize the donor organ and leave it unaffected.
The problem is that the new immune system can attack the recipient’s body as well, causing a potentially fatal reaction called graft versus host disease (Yours).
“The risk was considered very high,” Bertena said.
He developed a protocol to mitigate the risks
But he and his colleagues developed a protocol for reduce risk, Refining how donor stem cells are processed: They end up transplanting specialized cells, called alpha-beta T cells, that cause GVHD.
In the current report three children received mother cell His kidney was from the donor father and, five to 10 months later, he received the kidney itself. One child developed mild GVHD but was controlled with medication.
At present all three children are living together. kidney Fully functional for 22 to 34 months, without immunosuppressant drugs.
Jessica and Kyle Davenport from Muscle Shoals, Alabama are parents to two children. Jessica was a donor to her 8-year-old son, Cruz, while her 7-year-old sister Paisley received a transplant from Kyle.
“They’ve recovered and been fine, and they’re doing things we never thought possible,” Jessica Davenport said in a Stanford news release.
An important caveat is that all three children have a genetic disorder funny call shimke immunosuppressive dysplasia (SIOD). Along with kidney disease, SIOD causes short stature, immune system deficiencies, and other problems.
Bertena said the immunodeficiency seen in SIOD may actually be one reason the transplant approach works so well for these children.
“We need more research to see if this is effective for children with an intact immune system,” he said.
Blanchett also stresses that the effectiveness for children with normal immune function is not yet known.
Bertena is Hope this report will encourage more medical centers to do such research, The Stanford team has already expanded the approach to other patient groups, including children whose bodies rejected a previous kidney transplant.
Those patients, Bertena said, are generally “susceptible” and more likely to reject a new transplant. So by first giving them a new immune system, that obstacle can be overcome.
The last hope, said Bertena, is Extend the process to children and adultswith several underlying causes of their kidney disease.