Kidney location after transplantation. Adapted...

Kidney location after transplantation. Adapted from the original source to enlarge labels, and to fix a labelling error – “artery” and “vein” were transposed. See this discussion on the English Wikipedia. (Photo credit: Wikipedia)

Tarah Cordier (11 AM Microbiology) shares with this class the importance of proper universal precautions with patients who may be medically immunocompromised, and a potential therapy which may make such precautions medically unnecessary:

My sister and I had a kidney transplant December 13, 2005.  She had received a kidney from my mother nine years prior to that.  My mom actually had the last regular open surgery (her scar is a couple feet long and spans her entire abdomen) and by the time my kidney was removed, laparoscopic surgery was available (I have four 1 cm scars and one 2 in scar on my abdomen).  Unfortunately, my sister has not only had both types of surgeries but has also been on drugs that suppress her immunity almost her entire life.  She is constantly berated with infection and has spent a good portion of her life in and out of hospitals because of it.

The necessity for therapy to suppress immunity following renal transplantation is clear:  The recipient’s immune system will naturally reject the donor’s foreign kidney if immunosuppressing drugs are not given.  Immunosuppressant is a term used to describe a number of drugs or medicines that suppress or lower the body’s ability to reject a transplanted organ. These drugs are also referred to as anti-rejection drugs.  Prednisone and cyclosporine are included in this class of drugs.  According to the National Kidney Foundation, almost everyone who has a transplant must take immunosuppressant drugs post-operation.  Missing even one single dose of medication may result in rejection of the new kidney.  And as we should all know by now, taking them on time results in a weakened immune system and decreased ability to fight off infection. Certain types of cancer are also more prevalent in patients taking these drugs.  The only way you have a chance of possibly getting out of taking anti-rejection meds is if you receive your new organ from an identical twin.  Or is it?

Apparently, my sister and I were three years too late to opt in on the latest clinical trial.  In 2008, an ongoing study began in which kidney transplants are simultaneously conducted with bone marrow transplants.  Remember stem cells?  Researchers have discovered that when these transplants are done concurrently, a chimerism can be made.  The term chimerism is a general term for any mixing of cells.  In this case, the transplant recipient now has a mixture of immunological cells from his/her own body AND from the donor.  This can be extremely advantageous in preventing a kidney rejection.  Following transplantation, the recipient will be placed on steroids (anti-inflammatory) and maintenance regimens to suppress T cells.  These drugs are slowly tapered after two months.  So far, in a study of five patients, four of them were able to eventually withstand discontinuation of all immunosuppressive therapy with no effect on renal function.

Yay, stem cell research!


About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on April 17, 2013, in Guest Post. Bookmark the permalink. 1 Comment.

  1. The microbiology class and the topic on immunology, I have more appreciation for our innate and adaptive immunity. The great work of research in progress as stated above will be a wonderful breakthrough to organ transplant patients.

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