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NEW DRUGS, NEW APPROACHES MEAN NEW HOPE FOR TRANSPLANT PATIENTS Exciting Results With Mycophenolate Mofetil, Rapamycin; Non-heartbeating Donors Could Ease Organ Supplies; Introducing Embryonic Stem Cell Research

CHICAGO -- At The American Society of Transplantation Annual Scientific Meeting in Chicago, May 15-19, some of the world's top transplant physicians, surgeons and scientists unveiled studies of new immunosuppressive drugs that are offering new hope to heart, liver and kidney transplant patients.

Another study showed that non-heart beating donors are a promising source of organs for transplants. A bioethicist and a transplant surgeon also introduced the transplant community to a cutting-edge area of research: embryonic stem cells.

Promising new immunosuppressant drug helps heart transplant patients, in largest clinical trial. At the AST Annual Scientific Meeting, Jon Kobashigawa, MD of the UCLA Medical Center, discussed the largest double blind, randomized trial in heart transplant history of a new immunosuppressant drug, mycophenolate mofetil. The three-year study of 650 patients in 28 centers in North America, Europe, and Australia found that patients who received the drug did better than those who took the other drug in the trial, azthioprine. Patients treated with mycophenolate mofetil did better in terms of survival, had fewer early rejection problems, and resisted chronic rejection somewhat better. "I believe this drug is very promising," said Kobashigawa, "as it offers the first opportunity to improve survival rates in heart transplant patients, rates that have remained unchanged in the last ten years."

"Exciting" trials indicate rapamycin is an effective aid to immunosuppression Allan MacDonald, M.D., Director of the Transplant Program at Dalhousie University in Halifax, Nova Scotia reported on two large scale American and international trials of the immunosuppresive drug rapamycin. "What we have looks extremely promising. In fact it looks terrific," MacDonald said. In the two trials, more than 1300 liver and kidney transplant patients were treated with rapamycin in combination with other immunosuppressive drugs. The results of the trial, which will be reported for the first time at the meeting, show that patients who used a rapamycin combination did better in terms of rejection rates, graft losses and adverse events than control groups using other, more commonly used drug combinations. "This is a major development because rapamycin's mechanism of action is different from but complementary to presently available drugs, and it seems to work well in combination with current standard medications used to prevent rejection," MacDonald said.

Using organs from non-heart-beating donors will increase the supply of organs for transplantation At the AST Annual Scientific Meeting, Anthony D'Alessandro, M.D., University of Wisconsin, and Jimmy Light, M.D., Washington Hospital Center, will discuss their own experience using organs from non-heart beating donors as well as long term studies of the approach. D'Allessandro will focus on transplants from "controlled" patients (who are not brain dead, but from whom life support is being withdrawn). Light will discuss transplants from "uncontrolled" patients (who have died traumatic deaths). "Transplanting organs from non-heart beating donors will clearly result in an increased number of donors," says D'Allessandro. "And it works."

First-ever discussion of embryionic stem cells at a transplantation meeting will review progress, potential R. Alata Charo, professor of bioethics, University of Wisconsin, and Jon Odorico, MD of the University of Wisconsin will lead a discussion reviewing the state of research on embryionic stem cells. Laboratory studies are currently being done on both animal and human stem cells, which have the potential to someday replace or regenerate damaged organs. Charo and Odorico believe investigations in these areas might be of interest to transplant surgeons and clinicians. "We hope to help them learn more about current research and what it might mean for the field in the future," says Odorico.

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