Transplant patients from 40 years ago cause Pittsburgh doctors to take an ...( for five months. Before the new ...)

Before the new protocol, intestinal transplant patients would have been expected to take two to three immunosuppressives twice, sometimes three times, a day.

"Based on this clinical experience, we are proving that it is possible to decrease an intestinal transplant patient's need for post-transplant immunosuppression. While this is a tremendous step, it would be unwise to proceed too quickly. Having our patients take one pill two or three times a week for up to a year is a reasonable goal before we would consider complete withdrawal," reported Dr. Abu-Elmagd.

Close monitoring for rejection allowed researchers to intervene in four patients before serious damage to the grafts occurred. Their weaning schedule was then readjusted. Three other patients developed rejection that required an increase of their doses and the addition of other agents. All three were recipients of small intestines. One included a patient who had been taking tacrolimus once every two weeks when the rejection developed. Another patient is now back to being weaned after being successfully treated for a rejection that occurred when she was at a twice-a-week dose.

In other related presentations on tolerance, University of Pittsburgh today reported the following:

• Liver transplant patients who have been successfully weaned off immunosuppression have a lower level of a certain type of dendritic cell, reported George Mazariegos, M.D., associate professor of surgery at the Thomas E. Starzl Transplantation Institute. Dendritic cells present antigens to other immune system cells, and this particular type of dendritic cell is thought to accelerate the rejection response. The work is part of a larger effort funded by the Immune Tolerance Network to determine how it is that the transplanted organs of patients off all immunosuppression continue to be accepted by their immune systems without the aid of drugs. Researchers hope to identify pot
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