Study provides hope that some transplant patients could live free of anti-rejec...( STANFORD Calif. - People with organ...),Health

STANFORD, Calif. - People with organ transplants, resigned to a lifetime of anti-rejection drugs, may now have reason to hope for a respite, say researchers at Lucile Packard Children's Hospital and the Stanford University School of Medicine. Using a simple blood sample, the scientists have identified for the first time a pattern of gene expression shared by a small group of patients who beat the odds and remained healthy for years without medication.

The findings suggest that transplant recipients who share the same pattern of genes but are still on conventional medication may be able to reduce or eliminate their lifelong dependence on immunosuppressive drugs. The study may also help physicians determine how best to induce acceptance, or tolerance, of donor organs in all transplant patients, regardless of their gene expression profiles.

"We're very excited by the findings," said Minnie Sarwal, MD, PhD, a pediatric nephrologist at Packard Children's. "Most transplant patients who stop taking their medications will reject their organ. But now we have the chance of telling someone committed to a lifetime of drugs that it may be possible to minimize their exposure to the drugs."

Although the anti-rejection medications, known as immunosuppressants, tamp down the immune system enough to permit lifesaving organ transplants, their benefits come at a price. They also quash the body's natural response to dangerous invaders, such as bacteria and viruses, and to rogue cancer cells. Transplant physicians prescribing immunosuppressants to their patients walk a fine line between avoiding organ rejection and increasing the risk of infection and cancer.

Sarwal, associate professor of pediatrics at the medical school, is the senior author of the research, which will be published Aug. 20 in the advance online edition of the Proceedings of the National Academy of Sciences. She collaborated with physicians at Stanford and Packard Children's, as
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