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Transplant patients move a step closer to drug-free organ acceptance

By Bill Zeeble, KERA reporter

Transplant patients move a step closer to drug-free organ acceptance

Dallas, TX –

Bill Zeeble, KERA 90.1 reporter: Doctor Michael Ramsay, the President of Baylor Research Institute, says doctors learned - almost by accident,- that transplant patients don't always need anti-rejection drugs. 3 years ago, he was trying to contact the Medical Center's first liver transplant patient in 1984, a little girl, to celebrate the facility's two-thousandth transplant. But they could only reach her mother

Doctor Michael Ramsay, President, Baylor Research Institute: She recounted the transplant was successful and when she was on immuno suppressant drugs she was doing great, but really didn't like taking the drugs. And when she became a teen, she became rebellious and stopped taking the immuno suppression. There was silence. We all knew what that meant.

Zeeble: Ramsay reluctantly asked the mother what happened, afraid of the answer

Ramsay: She said, Well, she's now married, she's got a child and she's doing great.

Zeeble: Relieved, Ramsay was also surprised. In fact research now shows up to a 3rd of transplant patients do not need anti rejection drugs. These days, Baylor's part of a national study to genetically determine which patients might need few, or no drugs, and which ones could be weaned off them.


Zeeble: In a research lab, this machine kicks out a patient's genetic micro array - a color picture- derived from a single drop of blood. Doctors hope that by studying and comparing profiles, they'll spot genetic patterns indicating a tolerance for transplantation.

Nancy Bridges, Chief, Clinical Transplantaion, National Institute of Allergy and Infectious Disease, NIH : It's theoretically possible there's a signature we can identify, in blood, or maybe only in the transplanted organ, that would help us determine how much (if any) of the toxic anti rejection drugs a patient needs.

Zeeble: Nancy Bridges heads clinical transplantation at the National Institute of Allergy and Infectious Disease

Bridges: But we don't know what that signature is or how hard it'll be to find it.

Zeeble: Baylor doctors think they're pretty close. While no patient in any of several experimental programs has come off immuno-suppression drugs yet, one is on an exceptionally low dose.

Ambience, cafeteria

Todd Painter, liver transplant recipient: I used to take 7 mg twice daily, now I take 5 mg once a day.

Zeeble: Todd Painter sits in Baylor's cafeteria eating lunch during a day of tests. Two years ago, when he was 31, Painter received a transplanted liver after a decade with primary sclerosing cholangitis, a deadly liver disease. His genes showed he might do well on a limited dose of prograf, a standard anti-rejection drug, so he enrolled in the program

Painter: So I've been down to as little as 3mg but they had to adjust it depending on how my body reacts. Another perk to having this is I don't have to take steroids most transplant patients need to take

Zeeble: So far, Painter's doing fine, and feels it, despite fewer drugs

Painters: The ultimate goal is to take me off drugs completely. But not till my body's ready for it

Zeeble: That's what Doctor Klintmalm, Baylor's Chief of Transplantation, calls the holy grail. But even if that goal's not reached, he says patients will eventually be better off needing fewer powerful, sometimes dangerous drugs, and so will their wallet, because those drugs cost thousands & thousands of dollars a year. For KERA 90.1 I'm Bill Zeeble

Visit KERA's Life in the Balance page for more on health care issues