Study's goal: Drug-free after transplant

WASHINGTON -- Lindsay Porter's kidneys were failing rapidly when a friend offered to donate one of his. Then she made an unusual request: Would he donate part of his immune system, too?

Every day for the rest of their lives, transplant recipients must swallow handfuls of pills to keep their bodies from rejecting a donated organ. The Chicago woman hoped to avoid those problematic drugs, enrolling in a study to try to trick her own immune system into accepting a foreign kidney.

It's one of a series of small, high-stakes experiments around the country that has researchers hopeful that they're finally closing in on how to help at least some transplant patients go drug-free. The key: Create a sort of twin immunity, by transplanting some of the kidney donor's immune-producing cells along with the new organ.

"I'm so lucky," says Porter, 47, who stumbled across the research at Northwestern University. She was able to quit her pills last summer, a year after her transplant, and says, "I feel amazing."

These experiments are a big gamble. If the technique fails, patients could lose their new kidney, and possibly their lives. Doctors stress that no one should try quitting anti-rejection drugs on their own.

Why risk it even in a careful scientific study? Anti-rejection medications can cause debilitating, even deadly, side effects, from fatigue and infections to increased risk of cancer and kidney damage.

Without the drugs, "the hope for me is I'm able to keep this kidney for the rest of my life," Porter says.

Stanford University is testing a slightly different transplant method, and hosted a reunion earlier this month for about a dozen kidney recipients who've been drug-free for up to three years.

"These people who are off their drugs, they're cured," says Dr. Samuel Strober, who leads the study of Stanford's approach. "If they have to be on drugs the rest of their life, it doesn't have the same meaning of 'cure.' "

Anti-rejection drugs work by ratcheting down the immune system, suppressing it from attacking foreign cells. For decades, scientists have sought ways to eliminate the need for the drugs by inducing what's called tolerance -- getting one person's immune system to live in harmony with another person's tissue.

The experimental approach: Transplant the seeds of a new immune system along with a new kidney. It's the 21st century version of a bone marrow transplant, and possible for now only if the transplanted kidney comes from a living donor.

"We're at the very early phase of something that has generated a lot of excitement in the scientific community," says Dr. Laurence Turka of Beth Israel Deaconess Hospital in Boston, who is deputy director of the Immune Tolerance Network, a consortium founded by the National Institutes of Health to spur the field. "It has tremendous potential moving forward. Whether it will live up to its potential remains unknown."