Over the last half century kidney transplantation has become ever more successful, and is now the best treatment for many patients with kidney failure. Early results are outstanding and patients normally leave hospital with a well-functioning new kidney and quickly return to an active life.
The main problem for transplant patients and their doctors is that the immune system can reject and destroy the transplanted kidney, even after many years. To prevent this happening we use immune suppressing drugs to damp down the immune response, but these drugs have side-effects, such as making transplant patients more vulnerable to infection and to certain types of cancer, particularly skin cancer. Many patients still experience transplant rejection and may lose their kidney even when using the newest and most powerful immune suppressing drugs.
Doctors and scientists at Guy’s have been looking at different ways of controlling the immune system without immune suppressing drugs, a situation called Tolerance. The ONE Study is a new and ground-breaking research study into a more natural way of suppressing the immune system in kidney transplant patients.
During the study we will take blood from patients who are scheduled to receive a kidney transplant from a living donor. We will separate the white blood cells from the red blood cells and among the white blood cells we can identify and purify a particular type of immune suppressing cell called a regulatory T cell. We will grow these cells in the laboratory and 5 days after the kidney transplant, we will give them back to the patient using a ‘drip’. We want to see whether the cells will survive in the patient and whether they can alter the immune system so that it is less likely to reject the new kidney. If this more natural way of suppressing the immune response is successful this would allow us to use lower doses and fewer immune suppressing drugs so that patients would experience fewer side-effects.