New Discovery May End Transplant Rejection 201
mmmscience writes with this excerpt from the Examiner:
"Big news in the medical world: scientists in Australia have found a way to stop the body from attacking organ transplants, greatly decreasing the possibility of organ rejection. ... When a new tissue is introduced, one's immune system kicks into overdrive, sending out cells known as killer T cells to attack and destroy the unknown tissue. ... Professor Jonathan Sprent and Dr. Kylie Webster from Sydney's Garvan Institute of Medical Research focused on a different type of T cells — known as regulatory T cells (Treg) — in this study. Tregs are capable of quieting the immune system, stopping the killer T cells from seeking out and attacking foreign objects."
Organlegging (Score:5, Interesting)
About to donate... (Score:5, Interesting)
Autoimmune Diseases (Score:2, Interesting)
Allergies? (Score:5, Interesting)
Re:So they're doing another type of immunosupressi (Score:5, Interesting)
Hopefully they will be able to run positive clinical trials in the future. So far this is only effective on mice on relatively simple procedures (skin grafts, and pancreatic transfers). Kidneys, hearts, lungs are huge deals. I'm assuming if this hurdle is passed the doner would only need to have a blood-type match? That would be awesome and would make the waiting list that much simpler.
Tissue Rejection (Score:2, Interesting)
Is caused by the immune system not recognizing a foreign invader, the organ being transplanted.
No?
Then this guy wants to turn off that ability in the body?
Yes?
Historically speaking, whenever doctors have taken that approach it results in massive infection, and usually heart and lung problems.
You would think after so many complications from transplants, they would stop pursuing that direction.
Adult stem cell research seems to be the best approach to me. Same tissue so no rejection, and they do not have all of the problems fetal cells have. (i.e. Fetal stem cells have a nasty habit of becoming tumors.)
Somehow, Adult stem cells "know" what to do and when to stop growing appropriately much better than fetal stem cells when considering tissue regeneration in heart attack patients for example.
Not that doctors understand any of this process, but why they continue to invest so much money in transplant research is baffling. The quality of life for people financially and medically sucks for current transplant recipients.
-Hack
Re:So they're doing another type of immunosupressi (Score:3, Interesting)
2.) Also correct.
Immunosuppressant drugs, besides increasing the risk of infection and cancer, also screw with the kidneys, liver, and pancreas. So besides the fun 1-2 punch of increased risk of infection post-surgery and having a weaker immune system to fight it with, you can also have a delightful bouquet of metabolic issues to go with it. This treatment seems to take the "traffic control" route, instead of mass-nuking the entire T-cell population.
3.) If the rejection is hyperacute (immediate) or acute (several days to weeks after transplant), it's treatable. Chronic rejection, though, is irreversible and requires a lifetime of immunosuppressants. Exception: if bone marrow can also be transplanted, this effectively replaces the recipient's immune system with the donor's, so there is no rejection.
Overall, this looks pretty damn promising. If they could also figure out what happened with Demi-Lee Brennan, we'd be well on our way to Bioshock-style instant upgrades
Re:So they're doing another type of immunosupressi (Score:3, Interesting)
3) Not sure about this: I think that people need to take immunosuppressants for a LONG time after the transplant, thus pumping in toxins AND keeping the defenses low, where as this idea is a one time thing you do before the transplant and are then done with.
My father had a lung transplant about 5 years ago. You have to take the immunosuppressants forever with any inner body transplant (like heart, kidney, lung, etc). The immunosuppressants are quite good, but their side effects are significant and effect the life of a person. My father had to take significant amounts of pills daily at very specific times for everything to work properly. The pills also place quite a strain on the kidneys.
Bizarrely enough, that's what eventually killed him. The doctors (who, BTW, were outstanding) switched him to an immunosuppressant that was less stressful on his kidneys. The new drug had one very rare side effect that would eventually cause death. Dumb father didn't tell them he was having problems with new drug until it was too late and his body rejected the lung killing him. But Dad got 5 extra years that we wouldn't have had otherwise.
And the article is wrong about one point. The biggest problem for transplant recipients is not the drugs themselves. I.E. the effects on the body. That's bad. What's worse is the cost of the drugs and all the associated aftercare. The costs of the drugs are so great that unless one has a quite good insurance policy or a small fortune, your going to lose just about one's entire worth to pay for drugs. To me that's the second great advantage to this finding.
BTW, if anyone out there is looking for an outstanding lung transplant program, the program at Cedar Sinai Medical Center in Los Angeles is fantastic. The doctors are great, the support staff is first rate, and the care they give you is outstanding.
Re:So they're doing another type of immunosupressi (Score:3, Interesting)
That's not true, immunotherapies have historically not required permanent treatment. This isn't that much different from allergy shots or immunizations.
Eventually the body adapts to having the pathogens there and realizes they aren't harmful. The big concern with rejection is that the body will kill off the cells before that happens.
It depends upon the technique, but for many of the therapies it only takes 3-5 years, which even at double that is greatly superior to how we handle it now.
Mod parent down (Score:1, Interesting)
(unless maybe Score 5: Funny)
I'm a practicing transplant surgeon.
1. This story is not news at all - many methods of transplant tolerance have been successful in mice since the 1960s.
2. Transplants are complicated and require lots of people with specialized skills. A doctor could become a criminal, of course, but you would need a criminal transplant surgeon, criminal anesthesiologist, nurses, etc. as well as lots of specialized equipment and medicines that are only available to licensed practitioners (think audit trail) - not exactly the sort of thing that lends itself to black market activity. I can imagine this being done by rogue governments, though.
3. Rejection rarely causes graft loss these days anyway - less than 2% of organs fail from rejection in the first year.
Re:So they're doing another type of immunosupressi (Score:1, Interesting)
I will preface my post by saying that I had a living-donor renal transplant in September of 2005. This is very exciting news. Anything that can diminish the number of medicines and the frequency with which they need to be taken is great! Often, the side effects of the medication that you're taking can be very damaging to other aspects of your health. Infection is the number one cause of graft failure and patient morbidity in the first 24 months post transplant. Newer transplant drugs have brought about the diminish use of steroids and that has had a positive effect in both quality of life and graft survival. On the other hand, the cost of these medications is extremely high and it has increase the burden on insurance providers and patients.
If we can return the immune system to normal productivity the quality of life for the patient will be far greater and the burden on insurance companies and Medicare will diminish. This would be great news for the American taxpayer. Medicare shoulders the largest burden of transplantation costs. After 36 months, they no longer provide the patient with immunosuppressive coverage. This is a cost-saving move but at the same time the rates of graft rejection spike at 36 months because some patients are no longer able to afford medication.
In the United States, we have over 75,000 people awaiting a kidney transplant today. They are another 25,000 people awaiting various other organs. The burden to the US healthcare system and the Medicare system is incredible. We are very fortunate that we can keep people alive with dialysis but the cost of dialysis approaches $50,000 a year per patient. Medicare spends over $1 billion each year just for the drug EPO. A billion dollars!
I hope you will all join me in keeping up my fingers crossed and hoping that this is the breakthrough we've all been looking for!
Re:So they're doing another type of immunosupressi (Score:3, Interesting)
$80/month is less than what I spend on gas to get to work. Heck, annualize my computer purchases and I'd likely spend more on computer stuff than that. My telephone/internet costs more (cell phone, landline+DSL).
I assume you're talking about your copays?
That's the thing about insurance - when you're looking at costs to society, you need to include the whole cost, not just deductibles/copays. You generally end up paying the money eventually.
Anti-rejection drugs are not always needed (Score:2, Interesting)