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Drug may prolong organ life in noncompliant kidney transplant patients
Date:5/30/2008

New research from the University of California, San Diego Department of Medicine, Division of Nephrology, shows that the anti-rejection drug sirolimus (brand name Rapamune) may help prolong the clinical benefit of transplanted kidneys and delay rejection, especially in patients who do not regularly take their prescribed medications (are "non-compliant"). While the transplant field has been highly successful at reducing rejection and graft loss in the first year, post-transplant, reducing risk for graft rejection in the long-term has proved more difficult.

The findings are being presented at the 2008 American Transplant Congress (ATC), in Toronto on Saturday, May 31, 2008, by Cheri Ye, M.D., who was mentored by Robert Steiner, M.D., professor of medicine, and Director of Transplant Nephrology.

"No one is perfect at taking medications," explained Steiner. "But missing doses of immunosuppression, or not taking full doses each day, will bring about gradual rejection of kidney transplants that is almost impossible to detect in its early stages. Long acting drugs like sirolimus may help with this problem."

A team of five UC San Diego investigators reported a careful assessment of immune function at "trough" levels (lowest daily levels) of the three most commonly used immunosuppressive drugs, using an assay (ImmuKnow/ Cylex) designed specifically to measure the degree of immunosuppression at any given time. Lower "mitogenic response" meant better immunosuppression and more protection from rejection. On average, the participants, 160 kidney transplant patients, were 6.4 years out from their transplant.

At these trough levels of drug in the blood stream, the assay demonstrated that sirolimus caused a significantly lower level of mitogenic response, and results appeared to be stable in individual patients over time.

"At least half of transplanted kidneys are lost through chronic graft rejection, usually within 10
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Contact: Kim Edwards
kedwards@ucsd.edu
619-543-6163
University of California - San Diego
Source:Eurekalert

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