Double transplant frees patient from need for immunosuppres...( While organ transplants have been one...),Health

While organ transplants have been one of the great success stories of 20th century medicine, one of the downsides of the lifesaving procedures has been the requirement that organ recipients take powerful drugs to suppress their immune system for the rest of their lives. Now for the first time, physicians at the Massachusetts General Hospital (MGH) have deliberately induced a state of immune tolerance in a transplant recipient, enabling the patient to discontinue drug treatment without rejecting a transplanted kidney.

The patient, a woman who developed kidney failure as a result of a cancer of the bone marrow called multiple myleoma, received both a kidney transplant and bone marrow transplant from her sister in September 1998. As reported in the August 27 issue of Transplantation, the physicians' goal was to induce a state of mixed chimerism, in which the immune systems of donor and recipient are blended in a way that prevents rejection of the transplanted kidney by the recipient's body and suppresses an attack of the donor's immune cells on the recipient's organs, a dangerous condition called graft-versus-host disease. While the strategy was used in this patient to treat both kidney failure and the underlying malignancy, the accomplishment is an important milestone for the thousands of patients who require organ transplants each year.

"This is a first step toward the day when transplant recipients can be made tolerant to their donors' organs without the risks and costs of life-long immunosuppressive drugs," says Benedict Cosimi, MD, chief of the MGH Transplantation Unit and a primary author of the Transplantation paper. "We hope to be able to use this approach with less-closely-matched donors, providing even more options for patients needing transplanted organs."

Multiple myeloma is a cancer of the bone marrow that causes the proliferation of abnormal plasma cells. The result can be reduced levels of red cells and platelets, tumors at multipl
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Contact: Susan McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
25-Aug-1999