When Brenda Quale donated a kidney to Barb Okey last month, she gave her something else: part of her immune system.
In a new variant of the UW Hospital, some living kidney donors also excrete blood stem cells. which are infused into the kidney transplant recipients. The aim is to give the recipients a double immunity so they can take in the foreign organ without taking lifelong anti-rejection medications that are costly and have side effects, including kidney damage.
"It has always been a dream to minimize the damage significantly. Dixon Kaufman, transplant leader of the UW hospital. "We believe this will lead to a more durable, better-functioning kidney transplant."
Quale and Okey, sisters from Platteville, were the first couple to try the new approach at UW Hospital, part of a national study.
"It's great to lose anti-rejection medications," said Okey, 48.
"It'll be amazing if it works," Quale said. 54. "It's one thing to give."
Nearly 35,000 Americans received organ transplants from living or deceased donors last year. To prevent their bodies from rejecting their organs, they are constantly taking pills to suppress their immune system, increasing the risk of infection and chronic disease, and ultimately breaking down their new organs.
The study by Medeor Therapeutics – a San Mateo, California-based company based on studies at Stanford University, is replacing the donor's immune system with anti-rejection drugs.
In Madison, the trial began in late September when Quale took injections to boost stem cells in her blood. Nurses collected the cells through a blood filter machine at UW Hospital
On November 5, Quale donated a kidney to Okey through a regular transplant.
Okey began as usual with anti-rejection medications. She also got radiation for 10 days, which is not usually done. The radiation depressed her immune system and prepared her to take her sister's cells.
"We have partially suppressed Barb's immune system to make room for Brenda's immune system so they can mix," Kaufman said.
16, the last day of radiation, received Okey Immunes cells from Quale through an intravenous line. The cells had been shipped to Medeor for further processing.
Prior to her infusion, Okey was allowed to discontinue one of three anti-rejection medications. In a few weeks she will leave another. If all goes well, the doctors will wean them from the third in half a year and completely discard them.
Monthly tests to see if Quale's immune system is still in Okey. Typically, the recipients have about 85 percent of their immune system and 15 percent of their donor, Kaufman said.
"As long as there's a part of her sister's immune system, that's the same thing her donated kidney sees. it changes Barb's system so it does not reject the kidney, "he said.
So far, the approach has been limited to living donors and recipients whose tissue types are perfectly matched. Kaufman said that of the approximately 100 live donor transplants performed at UW Hospital each year, only four or five are perfect matches.
He works with Dr. Stanford's Sam Strober co-ordinated the technique for partially matching or mismatching pairs. The research is mainly concerned with rhesus monkeys, not with humans. Kaufman and Strober are scientific advisors to Medeor.
Similar studies at other centers infused the donor's blood stem cells into the recipient prior to kidney transplantation. Kaufman, however, said it could work later with deceased and living organ donors. It is not possible to select deceased donors and acquire their immune cells early, as is the case with living donors.
Quale, a nurse from Southwest Health at Platteville and Upland Hills Health at Dodgeville, had no problems with the immune system giving up cells along with her kidney. The cell-boosting injections made her feel she had the flu, and she had significant discomfort after surgery.
"I will not lie; it was rough But I feel much better now, "she said last week.
Okey is grateful that Quale, one of her four siblings, was medically and emotionally able to help.
Okey developed inflammatory kidney disease nearly 20 years ago. Last year it suddenly got worse and caused her doctor to say that she needed a transplant.
Due to the illness, she had to hold water, causing her arms and legs to swell. She became so tired that she could barely get through the day without sleeping. Nevertheless, she kept her job in the laundry of an assisted living facility.
Now that she's still recovering from her transplant, she's feeling better.
"I have more energy than I did before," she said. "I can stay awake all day."