Drug Could Benefit Organ Transplant Patients

    A recent study at the UCSD department of medicine’s division
    of nephrology suggests that the drug sirolimus may help prolong the benefits of
    transplanted kidneys and delay rejection, especially for “noncompliant”
    patients who do not regularly take their prescribed medications.

    Cheri Ye, M.D., presented the findings at the 2008 American
    Transplant Congress in Toronto on
    May 31.

    Ye’s mentor, professor of medicine and director of
    transplant nephrology Robert Steiner, said the drug — whose brand name is
    Rapamune — may be the answer to undetectable complications associated with
    kidney transplants.

    “No one is perfect at taking medications,” he said. “But
    missing doses of immunosuppression, or not taking full doses each day, will
    bring about gradual rejection of kidney transplants that is almost impossible
    to detect in its early stages. Long-acting drugs like sirolimus may help with
    this problem.”

    A team of five UCSD investigators assessed immune function
    at “trough” levels (lowest daily intake) of the three most commonly prescribed
    immunosuppressive drugs, measuring “mitogenic response” and the level of
    protection from rejection in 160 kidney-transplant patients.

    At these trough levels, sirolimus caused a significantly
    lower level of mitogenic response — representing greater protection — and
    results were stable in patients over time.

    “At least half of transplanted kidneys are lost through
    chronic graft rejection, usually within 10 years,” said David Perkins, professor
    of medicine and surgery and director of research for transplantation. “When
    patients do not have those rejection problems, they can go for 20 to 30 years
    before kidney rejection or other serious problems. This is an especially
    important issue now because of our nationwide donor-organ shortage.”

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