Screening for transplant rejection

Rejection is a major risk of transplant surgery

Scientists are developing a way to screen transplant patients at higher risk of rejecting their new organs.

The technique may enable doctors to individually tailor treatment for each patient, so that their immune response is suppressed and the threat of failure reduced.

It may also help some patients give up anti-rejection drugs that would otherwise have to take for life.

The technique is based on classifying patients by the genetic make-up of certain of their hormones that are involved in the immune response.

Using these genetic profiles, transplant doctors should be able to assess the best way to suppress the immune system.

A team from the University of Pittsburgh was able to work out the gene profiles of 81 patients who required a heart transplant, 29 organ donors and 50 control patients who did not require surgery.

They found that patients who were most likely to reject donor organs had a different pattern of hormone-like substances known as cytokines.

Cells use cytokines to communicate with each other, and to regulate the immune response.

Separate study

Meanwhile, in a separate study of 120 patients who appeared to be stable five years after undergoing transplant, doctors from the same university were able successfully to wean a third completely off anti-rejection drugs with no ill effect.

If you were a transplant patient three years post operation would you really want to give up your drugs when everything was going well

Mr John Forsythe, British Transplantation Society

Transplant patients are usually required to take anti-rejection drugs for the rest of their lives.

Such drugs can cause serious complications, such as tumour growth, and make patients more susceptible to infections.

Weaning was stopped in another third who experienced acute rejection.

The doctors hope that by using the screening technique they will in future be able to more accurately identify which patients can be weaned off drugs.

Mr John Forsythe, chairman of the British Transplantation Society, said the screening technique sounded interesting, and would be a great step forward if it allowed some patients to give up anti-rejection drugs.

But he said: "If you were a transplant patient three years post operation would you really want to give up your drugs when everything was going well, or would you prefer not to rock the boat?"

The results of the studies were presented at a conference of the American Society of Transplant Surgeons and the American Society of Transplantation.