Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Reducing anti-rejection meds after transplant shows less complications

13.12.2004


Transplant recipients have 96 percent survival rate after first year



Transplant researchers at the University of Pittsburgh’s Thomas E. Starzl Transplantation Institute have dramatically improved intestinal transplant graft survival, and reduced rejection and infection rates by successfully using a novel immunosuppression minimization protocol, thus improving patients’ overall quality of life and avoiding the use of several anti-rejection drugs, which can cause serious infections and major complications. Because the intestine is especially prone to rejection and infection, results of this innovative clinical protocol presented today at the 3rd International Conference on Immunosuppression at the Manchester Grand Hyatt, San Diego, are significant and have the potential to advance the field of organ transplantation.

"Transplant recipients do not want to be overwhelmed with a lot of anti-rejection medications, which can often lead to more complications. The fact that we have been able to significantly reduce the amount of anti-rejection drugs in this group of patients has enabled many of them to live full and productive lives," said Kareem Abu-Elmagd, M.D., Ph.D., F.A.C.S., professor of surgery at the University of Pittsburgh School of Medicine and director of the Intestinal Rehabilitation and Transplant Center at the University of Pittsburgh Medical Center’s (UPMC) Thomas E. Starzl Transplantation Institute and lead author of the study.


Of the 123 small bowel patients (65 intestine, 25 liver/intestine and 33 multivisceral) who received transplants under the immunosuppression minimization protocol since July 2001, 109 recipients are alive with 107 having functioning grafts. One-year survival rate is 96 percent. Sixty-nine percent of patients are taking a single dose of immunosuppression, some once a day, while others twice a week.

The protocol involves giving a one-time pre-transplant dose of either the drug thymoglobulin – a drug that kills and depletes T cells – key immune system cells 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 first year. The overall five-year patient survival rate is 70 percent and 10-year patient survival rate is 42 percent. An adult and child transplanted more than 14 years ago at the University of Pittsburgh are the world’s longest surviving recipients of a liver-intestine transplant.

In April 2001, the Centers for Medicare and Medicaid Services approved transplants of the small bowel, based on an appeal made by the transplant surgeons at the University of Pittsburgh.

Maureen McGaffin | EurekAlert!
Further information:
http://www.upmc.edu

More articles from Health and Medicine:

nachricht Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University

nachricht The first analysis of Ewing's sarcoma methyloma opens doors to new treatments
01.12.2016 | IDIBELL-Bellvitge Biomedical Research Institute

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: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>