Ingenious procedure enables kidney transplants without rejection

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

Reduce the risk of rejection without resorting to immunosuppressants during kidney transplantation

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

To reduce or eliminate the need for these compounds, doctors have tried transplanting Mother cells from donor to recipient, at the same time as your new organ. Starting in 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 body would consider the newly transplanted organ to be familiar, which would have the effect of reducing the risk of rejection. Unfortunately, these stem cell transplants carry significant risk: a condition called graft-versus-host disease, in which new immune cells inadvertently make their way to the transplant recipient’s body.

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Three patients with a rare immune disease

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

Transplant recipients, ages 7 to 8, have a rare immune disease called Schimke immunoosseous dysplasia (SIOD). It is characterized by chronic kidney failure requiring kidney transplantation and leading to bone marrow failure, which involves stem cell transplantation.

In the case of these three patients, one of the parents became a kidney and stem cell donor for their child. Doctors first performed the stem cell transplant and then five to 10 months later, once the boy had recovered from the operation, the kidney.

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Spectacular results

Today, 22 to 34 months after the second operation, his new kidneys are working perfectly and the children have returned to a normal life. ” They are true 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 Transplantation)The new procedure was approved by the United States Food and Drug Administration (FDA) for patients with certain pathologies that affect 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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