In short, patients at high risk of rejection have "bad" antibodies in their systems that would reject a transplanted kidney. IVIG contains "good" antibodies that block the ability of the bad ones to cause rejection.
Using therapeutic protocols developed for use in kidney transplantation -- one protocol for adults and the other for children -- Dr. Jordan is coordinating clinical trials that are sponsored by the National Institutes of Health. Begun in 1994, the studies are expected to provide statistical documentation to support the benefits that have been seen in clinical practice.
In the adult study, which will continue for the next several years, neither clinical staff nor patient knows who is receiving IVIG therapy and who is receiving a placebo. The pediatric trial, which is nearing completion, also started as a blinded study but was modified to "open-label" status to provide the medication for all children in the study.
Although the current studies are intended to prove or disprove the effectiveness of IVIG therapy in kidney transplant situations, the treatment also appears beneficial in heart, lung and liver transplants. According to a paper published in the Sept. 27, 1998 issue of "Transplantation," IVIG is recognized as an effective therapy in treating challenging forms of both heart and kidney rejection.
Dr. Jordan said IVIG therapy produces few side effects, and those are minor. The most common problem associated with the treatment is headache at the time of infusion.
While the uncertainty of donor organ availability makes it impossible to predict
each patient's course of treatment, the objective of therapy is to introduce
IVIG into the patient's system before transplantation and immediately thereafter
in an effort to modula
Contact: Sandra Van
Cedars-Sinai Medical Center