BETTER KIDNEY TRANSPLANT TREATMENT
More than 16,000 Americans receive kidney transplants each year. But transplant operations are no guarantee. The body can reject the organ. Now, a new therapy is giving many patients hope, and making the whole process easier to endure.
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Today, college student Hollis Henley is healthy, but a few months ago, kidney failure -- caused by a serious virus -- threatened his life.
Hollis Henley
Kidney Transplant Recipient
"My legs started swelling. I started getting real dark sores and lesions on my arms and leg."
First came dialysis, an exhausting process. Then, word that a kidney was available for a transplant.
Hollis Henley
"I called everyone to let them know, it was five in the morning."
The transplant was a success -- thankfully, his body accepted the kidney. But other patients aren't so lucky.
Dixon Kaufman, MD
Transplant Surgeon
Northwestern Memorial Hospital
Chicago, IL
"We always worry that a patient will have a rejection episode."
Surgeon Dixon Kaufman has found a way to reduce rejection that happens within the first six months after a transplant. An immunosupressant drug called alemtuzumab is the breakthrough. In 2001, Doctor Kaufman began giving it to kidney recipients instead of the usual drug of choice -- basiliximab. He found alemtuzumab cut early rejection rates in half.
Dixon Kaufman, MD
"We're seeing a lot of happy patients."
Alemtuzumab rarely carries side effects, and it doesn't require lifetime steroid use like the current therapy does. Steroids can cause bone disease, diabetes and weight gain.
Hollis is grateful for Doctor Kaufman's discovery.
Hollis Henley
"It's a blessing."
A blessing for all transplant recipients who can now live healthier, happier lives than ever before.
Doctor Kaufman says alemtuzumab may also help pancreatic transplant recipients, too. The drug is given to patients at the time of surgery. There are a number of reasons why people suffer kidney failure. Two reasons are high blood pressure or diabetes.
BACKGROUND: Kidney rejection is the earliest, immediate threat to a transplant. According to Dixon Kaufman, M.D., a Transplant Surgeon at Northwestern Memorial Hospital in Chicago, doctors always worry that a patient will have a rejection episode. Transplant rejection today occurs in about 20 percent of patients, which may sound high, but 10 to 15 years ago, the rate was more than 50 percent. This reduction is due to safer anti-rejection medications than were available in the past.
TREATMENT: Dr. Kaufman and colleagues compared the effectiveness of an immunosuppressive drug called alemtuzumab (Campath-1H) to the standard anti-rejection medication basiliximab. The goal was to find a safer, better-tolerated immunosupression treatment. In the past, patients have had to take steroids along with an anti-rejection drug, which is associated with side effects like weight gain, cosmetic problems, bone weakness, cataract formation, poor wound healing, high blood sugar and high blood pressure.
Researchers found the T-cell depleting agent Campath, given through the vein in the operating room in one dose, posed few side effects and was an inexpensive treatment method. Most importantly, almost none of patients had a transplant rejection early on (a few weeks after the transplant), compared to the 15 percent of patients who were on basiliximab. However, after a year, transplant rejection rates were about equal among patients on the two drugs. Still, Dr. Kaufman says Campath is advantageous, as it associated with few rejections early on, is less costly, and is easy to use. It is approved for treating leukemia but is not FDA-approved as a transplant rejection drug.
OTHER TRANSPLANTS: Doctors are now trying Campath in diabetic patients who have pancreas transplants. This population also often receives a kidney transplant as well. Dr. Kaufman says the rejection rate in this group 10 years ago was as much as 80 percent, but he says Campath has "worked terrifically." He adds, "We were the first center in the United States to get rid of the steroids in the pancreas transplant patients, and so we're, we're proud of that."
FUTURE: Dr. Kaufman says, "I think in the next six or seven years, the kinds of medicines we're going to use in transplants are going to be very different. They're going to be safer and easier for patients to take. They'll be easier on their bodies and there won't be as much infection or rejection, and the quality of life will still get better and better."
Andrew Buchanan
Northwestern Memorial Hospital
675 Nth Saint Clair
Ste 17-200
Chicago, IL
(312) 926-6503
anbuchan@nmh.org
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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