Mechanism found behind drug-free acceptance of transplants

When patients discontinue their regimen of immunosuppressants, the majority of them rapidly lose function of their transplants or grafts. In a small number of such patients, however, the transplants continue to work just fine.

VanBuskirk and her colleagues, including Dr. William J. Burlingham, associate professor of surgery at the University of Wisconsin, Madison, studied three patients from this unusual group, hoping to understand the mechanism of graft acceptance.

Two of the subjects were kidney transplant recipients who had stopped taking immunosuppressive medication 1.5 and 5 years after their transplants. The third patient had received a liver graft, and had gone off drugs -- by choice, like the others -- two years after the surgery. At the time of the study, the three grafts had been functioning well without drugs for 5, 28 and 4 years respectively.

The scientists developed a novel technique -- the trans-vivo DTH test -- to uncover the mechanism behind the transplant acceptance shown by these patients. They started by focusing attention on "delayed type hypersensitivity" (DTH) -- a common immune reaction that doctors use in the diagnosis of many infectious diseases, including tuberculosis.

In the tuberculin test, injecting a person's skin with material from the TB-causing micro-organism causes inflammation if the person has been infected by the germ at any time in the past. DTH is thus a memory response, since the immune system causes

Contact: Anne M. VanBuskirk
Ohio State University

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