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It is a small revolution in the medical world and more particularly in that of transplantations. Three American children, suffering from a rare disease, were transplanted with a kidney, without the need to take immunosuppressive drugs, usually prescribed for life after this kind of intervention.
After a transplant, the protocol is that patients are prescribed lifelong immunosuppressive treatment, which aims to limit the risk of rejection of the graft by the body and to put their immune system on standby.
However, for more than two years now, three American children who have been transplanted with a kidney, following a rare disease, live without taking the slightest immunosuppressive drug. And they might never need it. This feat is the subject of a publication in the journal The New England journal of medicinedated June 16th.
A valid approach for some patients
Could the researchers at the Standord University School of Medicine in California (United States) at the origin of what looks like a revolution have found a solution to the rejection of organ transplants? Not exactly, in the sense that the method they used would only work in certain cases and under certain occurrences.
Let’s remember: the 3 children who were transplanted suffered from an extremely rare disease called Schimke’s immuno-osseous dysplasia. This hereditary condition affects only about ten people in the world. It causes health problems, such as dwarfism, kidney failure or a weakening of the immune system.
This last particularity was decisive in the case of these 3 little patients. The researchers have indeed succeeded in transforming this weakness into an asset.
Reprogramming of the immune system
To achieve this result, they started from the postulate that the weakened immune system of children would allow them to reprogram it effectively so that it no longer considers the cells of the transplanted organ as foreign and, therefore, to be fought.
For each of the three operations, they transplanted the parents’ bone marrow, which contains stem cells, along with the donor kidney. Immunosuppressive treatment was given to the children before the operation and the transplanted organs were also treated to remove any immune cells capable of reacting once the transplant was completed.
No treatment needed two years later
Today, more than two years after these transplants, the transplanted kidneys and children’s immune systems are functioning perfectly, without anti-rejection medication. This is obviously an invaluable benefit for them, since immunosuppressive treatments can lead to serious side effects, such as cancer.
Due to the immune tolerance achieved in these three cases, “these kidneys will last a long time“, says Pr Alice Bertaina, geriatrician and author of the study. A major advance in the field of transplantation.
It remains to be seen whether this technique can one day be applied to all patients who require a transplant.