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Therapy Modulates Highly Sensitized Immune System to Let Mother Give Kidney to Daughter

for those with high exposure to “non-self” human leukocyte antigens (HLAs). Exposure may come through blood transfusions, previous transplantation or even pregnancy, when the mother is exposed to the father’s antigens, which are expressed in the cells of the developing baby. The immune system is then “sensitized” to those antigens – primed with antibodies to attack, even if the antigens arrive in the form of a potentially life-saving donated organ.

Stanley C. Jordan, M.D., medical director of Renal Transplantation and Transplant Immunology at Cedars-Sinai’s Center for Liver and Kidney Diseases and Transplantation, pioneered in the late 1980s the use of intravenous immunoglobulin (IVIG) as a way to reduce organ rejection among highly sensitized individuals. After undergoing years of experiments and clinical trials, IVIG became a fully accepted, Medicare-approved therapy in 2004 when it was found effective in a multi-center study partly funded by the National Institutes of Health.

IVIG modulates the immune system without suppressing it. In fact, says Jordan, the therapy actually boosts the immune system because the antibodies found in IVIG help fend off infections. For most of their highly sensitized patients today, IVIG therapy is combined with a new drug, Rituxan?, which brings treatment time down from about four months to one before transplantation, and the therapy can be used in both living-donor or cadaver-donor transplants.

Soraya says it may have been three or four months from the time she learned about IVIG and called Cedars-Sinai to the day of the operation. During that time her mother underwent many tests to make sure that she was as able a donor as she was willing.

“It seemed like it all happened very quickly,” Soraya says. “My mother and I went to Cedars-Sinai fairly soon after I talked to them and they tested both of us and said, ‘We can do something for you.’ I just remember thinking, you’ve got to be kiddi
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