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New Therapies Could Change Organ Transplants
Date:1/23/2008

ricking" the immune system into thinking the organ had come from the recipient. Both procedures also involved transplanting donor stem cells into the recipient.

"The ability to achieve tolerance in what's called stable chimerism [when donor cells are present in the recipient] in patients has been postulated since the 1960s," said Dr. Roy Smythe, chairman of surgery at Texas A&M Health Science Center School of Medicine. "It's really been a 'gee whiz' thing for the last 30 years. . . This is proof of principle in human beings, which is a big deal."

But, Smythe noted, forcing tolerance in transplant patients poses a fair bit of danger. "It's going to be tough at first, but the likelihood is, in the next 10 years, we will find less injurious and dangerous ways to prepare people for tolerance, so eventually it will be a safe thing to do. There's a long road to hoe yet, but it's going to happen. It's very exciting."

In the Sachs study, four of five patients who had HLA-mismatched kidney transplants were able to stop taking immunosuppressive drugs nine to 14 months after the transplant. Kidney function has stayed stable for up to 5.3 years since the transplantation.

HLA refers to human leukocyte antigens, which is one of the primary ways donors and recipients are matched. HLAs, found on the surface of virtually all cells, help tell the difference between normal body tissue and foreign substances.

All patients first underwent a procedure to partially destroy their bone marrow and reduce the level of T-cells (the part of the immune system most responsible for organ rejection). The bone marrow eventually regenerated and produced new immune cells which accepted the new organ.

The procedure had already been successfully performed on matched transplants.

Strober and his colleagues altered the immune system of a man who had received a closely matched kidney from his brother. The man has lived without immu
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