Organ transplantation :: Consortium to improve success of organ transplants

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), launched a three-site consortium spanning Boston, Cleveland and Philadelphia that will work to improve the outcomes of organ transplantation.

Although organ replacement prolongs survival for people suffering from end-stage organ failure, it rarely restores normal life expectancy and can sometimes lead to health problems associated with long-term use of immunosuppressive drugs, which reduce the risk of transplant rejection but also weaken the immune system against disease.

“The percentage of patients who live for a year after an organ transplant has risen dramatically over the past 15 years, but there has been only modest success in improving the odds of long-term survival,” says Anthony S. Fauci, M.D., director of NIAID. “This research consortium will move us closer to minimizing the debilitating, and sometimes fatal, complications of organ transplantation.”

“This consortium is part of our increased commitment to clinical research programs in immunology,” says Daniel Rotrosen, M.D., director of NIAID’s Division of Allergy, Immunology and Transplantation. “The information generated by this group will not only help us understand how the immune system recognizes and either accepts or rejects transplanted organs, it will also enable us to develop promising approaches to improving graft function and survival.”

The consortium will also receive support from two other NIH components, the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung and Blood Institute. Funding for the three five-year grants totals an estimated $43 million.

More than 25,000 organ transplants were performed in the United States in 2003, according to the Organ Procurement and Transplantation Network. As of August 2004, more than 86,000 people have their names on waiting lists for organs such as hearts, lungs, kidneys and intestines.

Obstacles to successful organ replacement include genetic incompatibility between donor and recipient and transplant rejection by the recipient’s immune system. Also, patients who take immunosuppressive drugs for a long period of time are more susceptible to conditions such as diabetes, high blood pressure, and loss of kidney function.

The consortium will, among other activities, seek to identify genetic factors in patients that could help doctors predict transplant outcomes as well as responses to post-transplant therapy; develop diagnostic tests that enable early detection and ongoing monitoring of immune- related processes; and test the safety and effectiveness of new, less toxic immunosuppressive drugs.

The three institutions in the consortium and the principal investigator at each are

– Brigham and Women’s Hospital, Boston, Mohamed H. Sayegh, M.D.

– Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Peter Heeger, M.D.

– University of Pennsylvania, Philadelphia, Abraham Shaked, M.D., Ph.D.

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