Study: Stem cell strategy could eliminate kidney transplant patients’ need for immunosuppressants

Editor's Note

A stem cell-based transplant method enabled most kidney recipients in a recent clinical trial to stop taking immunosuppressive drugs, according to a July 15 article in HealthDay.

As detailed in the article, the approach was tested in a phase 3 multicenter, randomized controlled trial published in the American Journal of Transplantation. It involved infusing kidney transplant patients with stem cells from their donors to induce immune tolerance. The trial included patients receiving kidney transplants from living siblings. Participants were randomly assigned 2:1 to either a treatment group or control group. The 20 patients in the treatment group received both a kidney and an investigational stem cell product (MDR-101) from their sibling donors.  

As detailed in the article and study abstract the study abstract, none of the 20 patients who received MDR-101 developed graft-versus-host disease. Nineteen of them (95%) were able to discontinue all immunosuppressive medications approximately one year after transplantation. Fifteen patients (75%) reached the primary endpoint of remaining immunosuppression-free for more than two years. Among the four patients who resumed therapy, two had recurrent immunoglobulin A nephropathy—one with concurrent rejection—and the other two had rejection or borderline biopsy findings.

The study reported no deaths, graft losses, development of donor-specific antibodies, or cases of graft-versus-host disease among treated patients. As detailed in the abstract, those who received MDR-101 also demonstrated improved quality of life compared to controls who received standard immunosuppressive therapy.

HealthDay notes that researchers believe this approach has the potential to reduce the long-term risks associated with immunosuppressive drugs, including infection, cancer, and medication side effects. However, as cautioned in the article,  further research is needed to determine whether the method could be successful in patients with less closely matched donors.