New Transplant Method Can Boost Kidney Acceptance

July 27, 2006 — -- At the sound of her coach's whistle, Jennifer Searl launched from the platform into the pool. She was swimming time trials while training for a triathlon, no small achievement considering that until recently Searl could barely walk, let alone swim.

"When I was in college I had to have a handicapped permit because it was too painful to walk," said Searl, now 26.

After undergoing a kidney transplant at age 13 because of kidney disease, she had to take powerful drugs, 25 pills a day, to prevent her body from rejecting the new organ. The drugs, she said, were far worse than the transplant surgery and left her with painful warts on her legs and feet, weakened bones and cataracts.

Even with the medication, Searl's body eventually rejected the kidney.

For her second transplant at age 22, she opted for an experimental treatment that would allow her body to tolerate the new organ without drugs.

Doctors began by using radiation and chemotherapy to weaken Searl's immune system. Then she received both a kidney and bone marrow to regenerate a new, compatible immune system from her donor -- her mother.

"We essentially fool the immune system into thinking the donor's organ is part of one's own body," said Dr. David Sachs, who pioneered the surgery at Massachusetts General Hospital.

The new kidney transplant procedure eradicates the need for those debilitating anti-rejection drugs that can cost up to $12,000 a year. That type of tolerance has been a long-standing goal for patients and surgeons.

"Tolerance, by definition, means the transplant is being accepted without the need for immunosuppression, and that is the holy grail," said Dr. Benedict Cosimi, a transplant surgeon.

While the procedure using chemotherapy and radiation promises to make patients' lives easier in the long run, there is significant risk upfront. Days before and weeks after the surgery, patients must remain in isolation, because they are vulnerable to dangerous, even deadly infections.

For 24-year-old Christopher McMahon, the fatigue and pain lasted for weeks.