 The
one bright spot in Peter Jones' day was attending his
six-year-old grandson Jason's school concert. You see,
while little Jason may yearn for the two front teeth that
he didn't get this Christmas, all Peter wants is a new
kidney so he can finally bid good riddance to his dreaded
dialysis machine. Peter is one of the 20% of 'highly sensitized'
end-stage renal disease (ESRD) patients, who have high
levels of 'anti-donor' antibodies, and hence a high likelihood
of organ rejection. Sadly, this can mean a life-sentence
of painful and costly dialysis. However, Peter must be
on Santa's list this year because a study published in
the December issue of the Journal of the American Society
of Nephrology details a therapy that helps prevent
organ rejection, offering fresh hope for patients like
him.
NO
FEAR OF REJECTION
The new treatment is based on intravenously injecting
immunoglobins, which are naturally produced in the body,
and have long been established as a therapy for immune
system disorders. According to lead author Dr Stanley
C Jordan of Cedars-Sinai Medical Center in Los Angeles,
the difference between intravenous injection of immunoglobins
(IVIG) and other anti-rejection drugs lies in modulating,
rather than suppressing, the immune system. "Most other
anti-rejection drugs can make the patient more susceptible
to infectious complications because they are globally
immunosuppressive," he explains. In contrast, IVIG "appears
to 'turn off' deleterious immune responses without damaging
the immune system, and in fact, it strengthens the immune
system because it provides antibodies to infectious
agents as well."
That's not all it does. In a study
that tested this therapy on 98 highly sensitized patients,
who either received IVIG or a placebo before kidney
transplantation, successful transplantation rates following
IVIG were more than double those of the placebo group.
Even more encouraging was that among high-risk patients
who had already had an organ transplant, transplantation
success was tripled.
Kidney transplants are only performed
on a low 3% of highly sensitized individuals due to
the increased risk of rejection. IVIG therapy can make
transplantation available to these patients, and as
Dr Jordan emphasizes, "there's no question that IVIG
therapy and transplantation have more to offer than
years of dialysis.
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