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Reducing anti-rejection meds after transplant shows less complications

that target the donor organ, or a similar drug called campath, which depletes both T and B cells, immune system cells involved in organ rejection.

Following transplantation, the 103 patients who received thymoglobulin and the 20 patients who received campath received the standard anti-rejection drug tacrolimus and none of the patients received steroids. Tapering of tacrolimus was attempted after 120 days.

While 43 percent of patients experienced some level of rejection before initial weaning, none showed evidence of chronic rejection. Patients under the campath protocol did slightly better than those treated with thymoglobulin.

Of the 123 intestinal transplants, 55 involved children, while the other 68 were adult cases.

The current success of this novel anti-rejection protocol should allow major improvement in both the long-term efficacy and quality of life after intestinal and multivisceral transplants, according to the researchers.

"This study, which is the first of its kind in the small bowel patient population at the University of Pittsburgh, was intentionally done because the intestine is an organ most capable of producing an immune response. With the success of reducing the anti-rejection drugs in these patients, we recommend this treatment regimen for other patients undergoing abdominal organ transplants (i.e., liver, kidney, pancreas) or thoracic organ transplants (i.e., heart or lung). At UPMC, the protocol has already been applied to the other organ transplant recipients, after the encouraging results with the initial intestinal transplant recipients," added Dr. Abu-Elmagd.

UPMC has more clinical experience with intestinal transplants than any other transplant center in the world. Since May 1990, more than 400 patients have undergone various intestinal transplants at UPMC. Survival rates also continue to improve each year; approximately 90 percent of patients survive after the f
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10-Dec-2004


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