SAVING LIVERS, SAVING LIVES
An organ transplant is the gift of life, but rejection can take that gift away. Now doctors have discovered a combination of drugs that cuts down on the number of rejections among those who receive a liver transplant.
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Tom Coletti remembers how he felt while he waited for a liver transplant.
Tom Coletti
Had liver transplant
"I was very weak. I couldn't walk up the steps, down the steps. I was crawling on my hands and knees."
Tom found a donor, and was given a new lease on life. But transplants are only half the battle. Preventing your body from rejecting that organ is another story.
Ignazio Marino, M.D.
Transplant Surgeon Thomas Jefferson University Hospital
Philadelphia, PA
"Rejection happens in at least 40 percent of patients undergoing a liver transplant."
With that goal in mind, Doctor Ignazio Marino and a team of researchers studied the effect of two anti-rejection drugs, basiliximab and tacrolimus. The medications were given to 50 liver transplant patients.
Ignazio Marino, M.D.
"These two drugs, used in combination, allowed us to have a significant decrease in the rejection. We went from about 40 percent rejection to only 12 percent."
Side effects were minimal. Doctor Marino says this treatment is a sign of good things to come.
Ignazio Marino, M.D.
"A transplant is not any longer a treatment to save a life momentarily. It is a treatment to give an excellent quality of life back to our patients."
Tom has not experienced any side effects. He's now back to his normal activities, taking walks with his wife, Joanna.
Tom Coletti
"I've never felt so great in my life."
And, now he's living with a little less to worry about.
Both drugs have been FDA approved. In the United States, cirrhosis, hepatitis b and c are the most common causes of liver failure. The liver is responsible for metabolizing food and fluids.
NEEDING A TRANSPLANT: Liver transplants are considered when there is a high risk of death from liver disease. There are several symptoms that might indicate the necessity for a liver transplant if they do not go away over time. These include: yellow skin or eyes, fluid in the legs or stomach, muscle thinning, easily bruising or bleeding, vomiting blood or passing blood in the stool, and concentration problems.
TRANSPLANT DETERRENTS: There are several things that might prevent you from being a good candidate for a transplant. These include: continuing to use alcohol or illegal drugs; being at high risk of using drugs or alcohol again after surgery; being unable to follow your doctor's instructions; not having an adequate support system post-op; having advance cancer of the liver; having another kind of cancer in recent years; having heart, lung, or kidney disease; having advanced HIV disease, and severe hardening of the arteries.
TRANSPLANT REJECTION: According to transplant surgeon Ignazio Marino, M.D., from Thomas Jefferson University Hospital in Philadelphia, liver transplant rejection happens in at least 40 percent of patients. He and a team of researchers have found a new combination of drugs that results in fewer incidents of rejection in liver transplant patients.
NEW DRUG COMBO: Dr. Marino and other surgeons analyzed the results of 50 liver transplant procedures they performed between 2000 and 2002. To prevent or lessen the severity of rejection, researchers used the monoclonal antibody basiliximab, as part of a group of drugs that included the standard anti-rejection agent tacrolimus and low doses of steroids. The addition of basiliximab lowered rejection rate to 12 percent. Results also show the drugs may have helped improve survival as well. Nearly 90 percent of the patients were alive three years after their transplant. This is about 10-percent higher than normal three-year mortality rates. Dr. Marino says in a little over a year of using this drug combination, the one-year patient survival is 100 percent. This is the first study that has evaluated the effectiveness and safety of tacrolimus and basiliximab to suppress the immune system to prevent the body's rejection of a liver. Researchers also expect less long-term toxicity because they used a lower dosage of steroids. Dr. Marino says as a result, fewer complications are expected to be associated with long-term steroid use, including hypertension, osteoporosis, and diabetes.
TACROLIMUS: Tacrolimus is FDA approved. The drug suppresses the immune system by inhibiting an enzyme crucial for T-cell proliferation, which is important in the immune process.
BASILIXIMAB: Basiliximab is also FDA approved. It prevents white blood cells from rejecting a transplanted kidney.
Transplant Program
Referral Number
(800) JEFF-NOW
www.jeffersonhospital.org/transplant
Copyright © 2004 Ivanhoe Broadcast News, Inc.
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