Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kidney transplant drug halves the early risk of rejection and allows less toxic treatment

28.07.2014

Oxford University scientists have shown that a powerful drug given at the time of a kidney transplant operation not only halves the early risk of rejection, but that it also allows a less toxic regimen of anti-rejection drugs to be used after the operation.

The key results are reported in The Lancet and presented at the World Transplant Congress in San Francisco today. They will help doctors faced with a difficult transplant conundrum: the powerful combinations of treatments used to prevent early kidney rejection may cause kidney damage later and may subsequently be a cause of transplant failure.

One of the main culprits is a class of drugs known as calcineurin inhibitors. These drugs are very effective at preventing rejection in the first weeks and months after a transplant, but their lasting effects can have serious consequences for the kidney later on.

Kidney transplantation is still the best treatment for patients with kidney failure, but much more subtle approaches are needed if success rates are to be improved.

Around 15,000 people undergo transplant in the USA every year and 2,000 in the UK. Patients need to take drugs to suppress their immune system in order to reduce the chances that it will 'reject' the new kidney. It is a risky procedure since disabling the immune system in this way can lead to an increased number of infections and cancer.

The 3C study (Campath, Calcineurin inhibitor reduction and Chronic allograft nephropathy) tested whether alemtuzumab (Campath; an anti-rejection treatment) partnered with low dose tacrolimus (a calcineurin inhibitor) could reduce transplant rejection when compared with existing treatment.

The study recruited 852 patients who underwent kidney transplantation in the UK between 2010 and 2013.

'Our primary aim was to find out whether alemtuzumab-based induction therapy would produce worthwhile reductions in acute rejection,' explained Chief Investigator Professor Peter Friend, from Oxford University's Nuffield Department of Surgical Sciences, 'but we also wanted to see whether we could use it with a lower dose of tacrolimus, because there is some evidence that tacrolimus contributes to long-term transplant failure.'

Among those allocated alemtuzumab-based induction therapy, 7.3% experienced acute rejection compared to 16.0% of those allocated basiliximab-based induction therapy – a halving in the risk of early rejection.

'These are important findings which we hope will guide treatments in the future,' said Professor Friend.

Although alemtuzumab has been available for many years, its use has been limited by concerns about possible side effects, in particular infections.

But no overall excess in serious side effects – such as infections and cancer – was found in patients on the treatment, the scientists report.

Medical Research Council-funded researcher, Dr Richard Haynes of the Clinical Trial Service Unit at Oxford University, said: 'The safety data from the 3C Study are reassuring. There was no overall excess risk of infections or other known complications of immunosuppression.'

Medical Research Council scientist Professor Colin Baigent, one of the other lead investigators, said: 'These results from the first 6 months of the 3C Study demonstrate the importance of large randomized trials in transplantation. The planned long-term follow-up of the 3C Study will provide a unique opportunity to investigate whether these differences in short-term outcomes translate into improvements in the long-term which will be of great interest to patients and their doctors.'

Dr Richard Haynes expressed his gratitude to all of the participants in the study: 'Without their help we would not have been able to make this progress towards improving the care of people who receive kidney transplants,' he said.

Prof James Neuberger, Associate Medical Director at NHS Blood and Transplant, said: 'NHS Blood and Transplant is delighted to be supporting this multi-centre UK study into the immunosuppression treatment of patients who have received a kidney transplant. We would like to congratulate the investigators on the good outcomes they are reporting and we hope these results will be sustained in the long term. Improving outcomes for patients and their families, will help us to achieve our aim to make every donation count and enable even more patients receive the transplants they need.'

###

Alemtuzumab-based induction treatment versus basiliximab-based induction treatment in kidney transplantation (the 3C Study): a randomised trial, published in The Lancet online, July 28, 2014 http://dx.doi.org/10.1016/S0140-6736(14)61095-3

Alemtuzumab is a lymphocyte-depleting agent (ie, it removes one type of white cell which is central to 'rejection' of transplanted organs – called lymphocytes – from the patient) unlike more commonly used treatments like basiliximab which block lymphocyte activation.

The 3C Study was funded by a research grant from the National Health Service Blood and Transplant (UK) and by grants from Novartis Pharmaceuticals UK and Pfizer. The study was designed, conducted, analysed and interpreted independently by the investigators at Oxford University and by the independent members of the study Steering Committee. The study was coordinated by the Oxford University Clinical Trial Service Unit (CTSU) which is funded by the Medical Research Council, British Heart Foundation and Cancer Research UK.

Andrew Trehearne | Eurek Alert!
Further information:
http://www.ox.ac.uk

Further reports about: drugs failure infections investigators rejection tacrolimus therapy toxic transplant treatments

More articles from Health and Medicine:

nachricht Using DNA origami to build nanodevices of the future
31.08.2015 | Institute for Integrated Cell-Material Sciences at Kyoto University

nachricht An ounce of prevention: Research advances on 'scourge' of transplant wards
28.08.2015 | University of Wisconsin-Madison

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Increasingly severe disturbances weaken world's temperate forests

Longer, more severe, and hotter droughts and a myriad of other threats, including diseases and more extensive and severe wildfires, are threatening to transform some of the world's temperate forests, a new study published in Science has found. Without informed management, some forests could convert to shrublands or grasslands within the coming decades.

"While we have been trying to manage for resilience of 20th century conditions, we realize now that we must prepare for transformations and attempt to ease...

Im Focus: OU astrophysicist and collaborators find supermassive black holes in quasar nearest Earth

A University of Oklahoma astrophysicist and his Chinese collaborator have found two supermassive black holes in Markarian 231, the nearest quasar to Earth, using observations from NASA's Hubble Space Telescope.

The discovery of two supermassive black holes--one larger one and a second, smaller one--are evidence of a binary black hole and suggests that supermassive...

Im Focus: What would a tsunami in the Mediterranean look like?

A team of European researchers have developed a model to simulate the impact of tsunamis generated by earthquakes and applied it to the Eastern Mediterranean. The results show how tsunami waves could hit and inundate coastal areas in southern Italy and Greece. The study is published today (27 August) in Ocean Science, an open access journal of the European Geosciences Union (EGU).

Though not as frequent as in the Pacific and Indian oceans, tsunamis also occur in the Mediterranean, mainly due to earthquakes generated when the African...

Im Focus: Self-healing landscape: landslides after earthquake

In mountainous regions earthquakes often cause strong landslides, which can be exacerbated by heavy rain. However, after an initial increase, the frequency of these mass wasting events, often enormous and dangerous, declines, in fact independently of meteorological events and aftershocks.

These new findings are presented by a German-Franco-Japanese team of geoscientists in the current issue of the journal Geology, under the lead of the GFZ...

Im Focus: FIC Proteins Send Bacteria Into Hibernation

Bacteria do not cease to amaze us with their survival strategies. A research team from the University of Basel's Biozentrum has now discovered how bacteria enter a sleep mode using a so-called FIC toxin. In the current issue of “Cell Reports”, the scientists describe the mechanism of action and also explain why their discovery provides new insights into the evolution of pathogens.

For many poisons there are antidotes which neutralize their toxic effect. Toxin-antitoxin systems in bacteria work in a similar manner: As long as a cell...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Networking conference in Heidelberg for outstanding mathematicians and computer scientists

20.08.2015 | Event News

Scientists meet in Münster for the world’s largest Chitin und Chitosan Conference

20.08.2015 | Event News

Large agribusiness management strategies

19.08.2015 | Event News

 
Latest News

Production research by Fraunhofer IAO honored with three awards at the ICPR 2015

31.08.2015 | Awards Funding

Single-Crystal Phosphors Suitable for Ultra-Bright, High-Power White Light Sources

31.08.2015 | Materials Sciences

Manchester Team Reveal New, Stable 2D Materials

31.08.2015 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>