Ingenious procedure enables rejection-free kidney transplants

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Three children with a rare genetic disease needed kidney transplants. Using a unique transplant technique, doctors were able to replace their organs without the need for immunosuppressive drugs.

Reducing the risk of rejection without resorting to immunosuppressants during kidney transplants

Generally, after receiving a graftorgan recipients must take immunosuppressive drugs for the rest of their lives, to prevent their immune system from rejecting it. These patients are thus more prone to infections and cancers, and even in this case, immunosuppressants do not completely eliminate the risk that their body will eventually attack the organ.

To reduce or eliminate the need for these compounds, doctors have tried transplanting stem cells from the donor to the recipient, at the same time as his new organ. From the bone marrow, these differentiate into different types of blood cells, including types of immune cells called lymphocytes which signal the presence of any foreign body in the body.

In theory, since these stem cells come from the donor, the recipient’s organism would consider the newly transplanted organ as familiar, which would have the effect of reducing the risk of rejection. Unfortunately, these stem cell transplants carry a significant risk: a condition called graft-versus-host disease, in which the new immune cells inadvertently target the transplant recipient’s body.

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Three patients with a rare immune disease

In the context of works published in the New England Journal of Medicinedoctors from Stanford developed an innovative approach to transplant reins and stem cells in patients. So far, none of the three patients who underwent the procedure required immunosuppressive therapy or developed graft disease.

Aged 7 to 8 years old, transplant recipients suffer from a rare immune disease called Schimke immuno-osseous dysplasia (SIOD). This is characterized by chronic kidney failure requiring kidney transplantation, and causes bone marrow failure, involving stem cell transplantation.

In the case of these three patients, a parent became both a stem cell and kidney donor for their child. The doctors first performed the stem cell transplant and then, five to ten months later, once the child had recovered from the operation, the kidney.

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Spectacular results

Today, 22 to 34 months after the second operation, their new kidneys are working perfectly and the children have returned to a normal life. ” They are real walking miracles said the mother of one. ” In addition to not needing immunosuppressive treatments, they no longer show signs of SIOD. »

baptized DISOT (Dual Immune Solid Organ Transplant)the new procedure was approved by the US Food and Drug Administration (FDA) for patients with certain pathologies that have an impact on the kidneys.

Hoping that the approach will soon be approved as a treatment option for many more patients requiring such a transplant, the team plans to study the possibility of adapting it for other solid organ transplants.

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