Findings: Transplant risk identified

September 6, 2002

Transplant patients are routinely fed cocktails of the highest doses of drugs to prevent organ rejection. These drugs are highly toxic, so tailoring the exact dosages to each patient could avert unnecessary side-effects. A Manchester University immunologist believes he may be the first to do this.

Ian Hutchinson has been working on how genetic diversity affects organ transplants in a bid to identify people most at risk of transplant rejection.

The immune systems is controlled by hormone-like molecules called cytokines. These promote or suppress responses such as allergies or asthma, inflammatory or auto-immune conditions such as rheumatoid arthritis or diabetes. Establishing the level of a particular cytokine that an individual is programmed to produce has enabled Professor Hutchinson to begin to predict who is prone to organ rejection.

The research team focused on kidney transplants and found that 80 per cent of acute rejection occurs in 20 per cent of patients. These people's immune systems were found to be genetically programmed to produce a high level of the cytokine known as tumour necrosis factor, which encourages an inflammation.

"The same genotype defines people who are prone to reject their hearts so fiercely that once it starts it is unstoppable and they die," Professor Hutchinson said. "These patients need the closest monitoring and the most effective treatments."

As yet, routine genotyping of patients is rare. But some units are beginning to change. And Professor Hutchinson believes the research can be extended beyond transplantation to various forms of infection or even cancer.

Professor Hutchinson presented his research at the Transplantation Society Congress in Miami last week.

Caroline Davis

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