HOLLYWOOD, Fla., Aug. 26 (UPI) -- Researchers said Monday that they can dramatically reduce the anti-rejection drugs needed by transplant recipients to make sure the life-saving organs function properly.
Instead of daily doses of medication, doctors said some patients might be able to get by with taking the drugs just one day a week, and eventually they might not need to take any anti-rejection drugs at all.
Researchers at the International Congress of the Transplantation Society in Hollywood cautioned, however, that the reduction is being tried in a few select cases and might not apply to most people now taking anti-rejection drugs.
"We do not think that reducing the amount of drugs people take is an experimental procedure," said Dr. Thomas Starzl, a pioneer in human organ transplantation and professor of surgery at the University of Pittsburgh in Pennsylvania.
He added, however, weaning a patient off anti-rejection drugs is a process that must be begun early in the treatment stage.
Dr. Kareem Abu-Elmagd, professor of surgery at the University of Pittsburgh, said one of his patients who received a small bowel transplant is taking anti-rejection drugs once a week, five other patients are taking drugs three times a week and another five are taking drugs every other day.
The process of weaning transplant patients off drugs begins after they have been free of rejection episodes for at least 90 days.
Dr. Samuel Strober, professor of immunology and rheumatology at Stanford University School of Medicine, Stanford, Calif., was able to wean kidney transplant patients off immunosuppressant drugs for as long as five months before rejection episodes were detected.
In India, Dr. H.L. Trivedi, director of the Institute of Kidney Diseases and Research Center at Civil Hospital, Ahmedabab, reported he was able to take patients off powerful anti-rejection drugs for at least four months in his ongoing clinical trials. The patients are maintained on less potent immunosuppressant drugs.
Starzl said the move to reduce the drugs is almost as old as transplant technology, and has roots in early trials in which several transplantation patients -- including several who still are alive -- have maintained functioning kidneys for more than 30 years without taking immune system suppressants.
Strober said the advantage of getting patients off immunosuppressants, such as cyclosporine and tacrolimus, is that the organs tend to last longer and patients don't suffer adverse side effects from a lifetime of systemic immunosuppression.
As impressive as the trials appear, Dr. Allan Kirk, chief of the transplant surgery section of the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, Bethesda, Md., urged caution.
"All these trials have been done at very excellent centers," he noted, "but I don't think this is ready for prime time. We have to realize that for the vast majority of organ transplant patients, those who have stopped taking anti-rejection drugs have lost their grafts."
"All the people mentioned in these trials are still on some form of immunosuppressant medicine," said Megan Sykes, professor of surgery at Massachusetts General Hospital/Harvard Medical School, Boston.
She suggested there may be conditions that could make it possible for transplant patients to avoid medicines but further studies are needed.
