A new treatment might open the door for more patients with advanced kidney disease to get a transplant, a preliminary study suggests.
Of the 100,000-plus Americans waiting for a donor kidney, about one-third are “sensitized,” said Dr. Robert Montgomery, director of the Transplant Institute at NYU Langone in New York City.
Those patients face a tough situation: They harbor immune system antibodies that are primed to attack a donor organ.
The antibodies can form when a person is exposed to foreign tissue, Montgomery explained. So a patient who’s had a prior kidney transplant may be highly sensitized — meaning they have a large number of the offending antibodies.
It can also happen to patients who’ve had blood transfusion or ever been pregnant, Montgomery said.
It’s almost impossible to find a compatible donor for those patients. But they might be able to receive a kidney from an incompatible donor if they first undergo an extensive “desensitization” process.
That involves various treatments — including IV drugs called immune globulin and rituximab — that try to quash the antibodies that would attack the donor organ.
Now the new research suggests a simple approach — an infusion of a particular enzyme hours before the transplant — could offer a better alternative.
Researchers found that the treatment — dubbed IdeS — quickly wiped out the dangerous antibodies, allowing all but one of 25 patients to have a successful transplant.
The study’s findings were published in the Aug. 2 issue of the New England Journal of Medicine. Funding for the study came from the company developing IdeS — Hansa Medical.
Montgomery, who was not involved in the study, said he’s “never seen anything like it.”
“When you give this, all of the antibodies are gone,” Montgomery said. “I’m hopeful that this will turn out to be a game-changer.”