Researchers Find Drug that Reduces Rejection Risk for Kidney Transplantation by Half

Researchers at Oxford University have found a drug that will help reduce the risk of rejection in those undergoing kidney transplants and also allow a less toxic treatment.

Certain drugs such as calcineurin inhibitors used to reduce the risk of rejection among patients undergoing kidney transplants have serious perils associated with it.

Researchers argue that despite kidney transplantation being a superior treatment, more subtle approaches are needed to improve the success rates. In the United States, at least 15,000 people undergo kidney transplant every year. Patients are required to take drugs to suppress their immune system to reduce the chances of rejection of the new kidney. The procedure is considered dicey as disabling the immune system leads to various other infections and cancer.

The 3C study (Campath, Calcineurin inhibitor reduction and Chronic allograft nephropathy) tested whether alemtuzumab (Campath; an anti-rejection treatment) partnered with low dose tacrolimus (a calcineurin inhibitor) could reduce transplant rejection when compared with existing treatment.

For the study, the researchers examined 852 patients who underwent kidney transplantation in the United Kingdom between 2010 and 2013.

"Our primary aim was to find out whether alemtuzumab-based induction therapy would produce worthwhile reductions in acute rejection," explained Chief Investigator Professor Peter Friend, from Oxford University's Nuffield Department of Surgical Sciences in a press release. "But we also wanted to see whether we could use it with a lower dose of tacrolimus, because there is some evidence that tacrolimus contributes to long-term transplant failure."

The team noted that among patients who were given alemtuzumab-based induction therapy, 7.3 percent had acute rejection compared to 16.0 percent of those administered with basiliximab-based induction therapy - halving the risk of early rejection.

"These are important findings which we hope will guide treatments in the future," said Professor Friend.

Researchers said that the alemtuzumab has been available for years, however, its use has been limited by concerns about possible side effects, in particular infections.

The research team did not find overall excess in serious side effects such as infections and cancer.

"The safety data from the 3C Study are reassuring. There was no overall excess risk of infections or other known complications of immunosuppression," said Dr Richard Haynes of the Clinical Trial Service Unit at Oxford University.

Medical Research Council scientist Professor Colin Baigent, one of the other lead investigators, said, "These results from the first 6 months of the 3C Study demonstrate the importance of large randomized trials in transplantation. The planned long-term follow-up of the 3C Study will provide a unique opportunity to investigate whether these differences in short-term outcomes translate into improvements in the long-term which will be of great interest to patients and their doctors."

The research findings were published in The Lancet and presented at the World Transplant Congress in San Francisco recently.