A recent study showing that transplants of mismatched kidneys in monkeys achieved long-term success without the need for chronic immunosuppression may represent an important step in the field of transplantation.
CNN called the finding "an advance that could help tens of thousands of people."
In the study (Proc Natl Acad Sci USA 1997:94;8789-8794), Allan D. Kirk, MD, PhD, and colleagues at the University of Wisconsin Hospital and the Naval Medical Research Institute treated 12 monkeys who had undergone kidney transplantation with no immunosuppression, with CTLA4-Ig alone, with the CD40L-specific monoclonal antibody 5C8 alone, or with a combination of the two. The combination proved to be 100 times more effective than either agent alone, and three of the four monkeys who received the combination experienced prolonged survival without chronic immunosuppression.
Although similar findings have been reported in rodents, the new research is a step closer to the possibility of transplantation without chronic immunosuppression in humans.
"The key thing is that this validates a method that does not require chronic immunosuppression in a species very close to man." Dr. Kirk told TNN Transplant News Network.
However, Dr. Kirk urged caution in interpreting the results. "Like every other advance, it's an incremental advance, and we would like to downplay its individual importance as much as possible," he said. Although the ultimate goal is to transplant an organ without needing immunosuppression, "just minimizing the immunosuppression would be a significant step," he added.
For Your Information:
Allan D. Kirk, MD, PhD
Naval Medical Research Institute, Bldg. 18, 8901 Wisconsin Ave., Bethesda, MD, 20889
301-295-1379
kirka@nmripo.nmri.nnmc.navy.mil
PNAS Online full text: http://www.pnas.org/cgi/content/full/94/16/8789
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