Assistant professor of surgery Maria Millan transplants almost 300 organs annually, but she’s particularly pleased with the results for two of her most recent patients. After receiving transplanted kidneys from nonrelatives, they were weaned off antirejection drugs. One remains off the medication.
Previously, transplant patients had to take immunosuppressive medications for the rest of their lives to prevent rejection—and the drugs can have severe side effects, including heart problems and malignancies. But now, teams of Stanford researchers and specialists have developed a new therapy that combines injected blood stem cells from the organ donor with small doses of radiation and medication. The protocol, which was presented to the American Transplant Congress and appeared in the journal Transplantation in May, aims to create a hybrid immune system that accepts the transplanted organ, rather than attacking it as something foreign. “The organ becomes recognized by the body of the recipient as self,” Millan says.
The new therapy draws on 30 years of research—with laboratory animals and in human trials—conducted by Samuel Strober, professor of immunology and rheumatology, who often functions as a de facto communications center for keeping the surgeons, nephrologists, immunologists, pathologists and experts in bone-marrow transplantation and radiation oncology in touch with one another. Although the protocol was tested using live donors, it is designed largely for transplants from cadavers, at a time when an estimated 79,000 people nationwide are waiting for organ replacement—and 6,000 died last year while they waited. “These transplants are life-saving procedures and are able to return patients to a normal lifestyle, which is a very impressive outcome for someone with a basically terminal illness,” Strober says.
Millan, who will help refine the therapy as she and her colleagues do living-donor kidney transplants and cadaver liver transplants, says she’ll consider it a success when her patients remain off medications for two years. “My first priority will always be the patient,” she says. “We’re really talking about the quality of their lives.”
