Donating a kidney may save a person's life - but only if the conditions are precise.
Kidney donors must be related and immunologically matched to their donors – and even then, the recipient must take a lifetime of anti-rejection medications, which don’t guarantee the organ won't be rejected.
But a new clinical trial from Northwestern Memorial Hospital in Chicago, Ill. has shown how stem cells can be used to “trick” a recipient’s immune system into believing the new organ has been part of that person’s body all along.
The breakthrough has the potential to eliminate both the risks associated with kidney transplantation and the need for anti-rejection medications within one year after surgery.
“It’s the holy grail of transplantation,” said lead author Dr. Joseph Leventhal, transplant surgeon at Northwestern Memorial Hospital and associate professor of surgery and director of kidney and pancreas transplantation at Northwestern University Feinberg School of Medicine in Chicago, Ill. “This notion of being able to achieve tolerance through donor derived cells has been around for more than 50 years, but it’s translation to the clinic has been quite elusive. This article details the first successful attempt of this in mismatched and unrelated kidney recipients.”
The research was published Wednesday in the journal Science Translational Medicine, and it is the first study of its kind in which the donor and recipient were not related and did not have to be immunologically matched. Only 25 percent of siblings are immunologically identical, severely limiting the possibility of being a kidney donor.
The procedure worked by extracting a little bit more from the kidney donor than just their kidney. They also donated part of their immune system. About one month before surgery, bone marrow stem cells were collected from the donor and then enriched with “facilitating cells” – becoming stem cells that will ultimately fool the donor’s immune system allowing the transplant to succeed.