Handling Rejection: Drugs, Treatment Boost Transplant Survival
In addition, people who had received daclizumab were much more likely to
have a functioning heart after the transplant procedure than the other patients
were, report Ainat Beniaminovitz, MD, and colleagues at Columbia-Presbyterian
Medical Center in New York.
But new drugs alone can't account for improved transplant survival rates,
says Charles B. Carpenter, MD, professor of medicine at Harvard University
School of Medicine and senior physician at Brigham and Women's Hospital in
Boston, who wrote an editorial accompanying the studies. Carpenter points out
that progressive increases in transplant survival over the last several years
took place in the era of multiple drugs like cyclosporine and
"What the study [by Hariharan and others] does not address are the
possible contributions of better clinical care," such as better treatment
of high blood pressure, more effective treatment and prevention of serious
infections, and an increased use of better-matched kidneys from recently dead
donors, according to Carpenter.
Carpenter tells WebMD that in spite of the improvements in kidney
transplants in the last several years, a significant shortage of available
organs still exists. Many patients still have to stay on kidney dialysis
machines and some even die from kidney failure while waiting for an acceptable
Improving the care of patients after receiving a kidney transplant, combined
with current or future anti-rejection therapies, could partially ease the
current organ shortage, he says.
"We're in a bear market," Carpenter says. "Every year we get
further behind and it keeps going down." Doubling the survival time of
transplanted kidney through better use of immune-suppressing drugs would be
"virtually the same as doubling the donor supply."
- Today's kidney and heart transplant patients have a better chance of
avoiding rejection of their new organs, compared to patients in the 1980s.
- Drugs such as cyclosporine for kidney recipients and daclizumab in heart
transplant patients have significantly boosted the survival of the new
- Observers note drugs should not get all the credit, however, as doctors
today are more skilled in controlling blood pressure and infection as well as
in getting better-matched organs. All together, these improvements help reduce
the number of treatment failures, which eases the overwhelming demand to
provide new organs to so many sick patients.