2023-09-25 13:18:16
Aditi Shankar, an 8-year-old British girl, underwent a double transplant: a kidney and bone marrow stem cells [1] coming from his mother were grafted to him [2]. In ” reprogramm[ant] its immune system so that it recognizes the organ as its own », this protocol aims to avoid taking immunosuppressants for life (see To prevent the heart transplant from being rejected, a liver is also transplanted). The doctors will present their results during the conference of the European Society of Pediatric Nephrology this week.
A recent method
This protocol is called “ double immune/solid organ transplant “. It was developed by researchers at Stanford University and approved by the Food and Drug Administration (FDA) en May 2022 [3].
Hematopoietic stem cell transplantation confers a genetically new immune system », these cells convert into blood immune cells. To prevent graft-versus-host disease (GVHD)[4]the team of Alice Bertaina, one of the designers of the technique, modified it [5].
Aditi underwent the kidney transplant 6 months after the bone marrow stem cell transplant. She is now back at school.
Towards an expansion of the protocol
Kidneys from deceased donors are functional for an average of 11.7 years. A duration which increases to 19 years in the case of living donors.
The Stanford researchers plan to expand their protocol to more types of patients, such as children who, having received a first kidney, reject them. They also wish to adapt it to the transplantation of organs from deceased donors (see Kidneys from newborns transplanted to adults?).
[1] hematopoietic
[2] The little girl suffers from Schimke’s immunoosseous dysplasia (SIOD), a hereditary disease that weakens the immune system and leads to kidney failure. The technique used must also strengthen your immune system.
[3] A. Bertaiana, Sequential Stem Cell–Kidney Transplantation in Schimke Immuno-osseous Dysplasia, N Engl J Med 2022; 386:2295-2302 DOI: 10.1056/NEJMoa2117028
[4] This technique presents the risk that the cells will attack those of the host. Graft-versus-host disease can be fatal in severe cases.
[5] « After collecting the donor stem cells, researchers deplete (reduce) the alpha-beta T cells “. Afterwards, ” 60 to 90 days after surgery, the patient’s alpha-beta T cells return to normal levels and restore optimal immune function ».
Source : Trust my science, Vasiloa Rasolofo and J. Paiano (23/09/2023)
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