New NHS immune cell jab could reduce kidney transplant failures – as army veteran sees trial success
British doctors are pioneering a groundbreaking treatment that uses patients’ own blood to reduce the risk of organ transplant failure.
The advanced technique results in a reduction in the number of failed transplants and also reduces the number of anti-rejection drugs patients need to prevent the immune system from destroying the new organ. These drugs, taken daily, significantly increase the risk of cancer, heart disease and diabetes.
But the new treatment, being offered to kidney transplant patients at the Oxford University Hospitals NHS Foundation Trust, could potentially protect donor organs with a much lower dose of the toxic pills – if not none at all.
Every year, around 3,000 people in the UK undergo a life-saving kidney transplant and then need powerful tablets for the rest of their lives to dampen the immune system.
Chris Holmes, a former Army paramedic who served in Afghanistan, is one of more than 150 patients worldwide participating in the trial
The new treatment is being offered to kidney transplant patients at the Oxford University Hospitals NHS Foundation Trust. Pictured: The West Wing at John Radcliffe Hospital in Oxford
The downside is a three-fold increase in the risk of some cancers — such as lymphoma, which affects the lymph nodes — as well as an increased risk of heart disease. In some cases, the drugs even damage the organ they are supposed to protect.
The new approach instead harnesses the power of the immune system itself.
Six weeks before the transplant surgery, doctors take a blood sample from the patient and extract cells from the immune system called regulatory T cells. These cells have the job of curbing the immune system’s response to attacks so that it doesn’t end up harming healthy cells. The problem is that regulatory T cells occur naturally in the blood in very low numbers. So doctors take out what they can and grow up to ten times as many of these cells in the lab before being frozen.
Four days after the transplant, they thaw the sample and slowly inject it back into the bloodstream.
The cells are attracted to the new kidney due to the inflammation resulting from the surgery. Once there, they dampen the response of other immune system cells trying to attack it.
dr. Paul Harden, a kidney specialist involved in the trial, says: ‘It’s not just about the number of cells. Research shows that once in the bloodstream, regulatory T cells also “recruit” other cells of the immune system to behave the way they do. The treatment currently consists of one infusion.’
The success of the trial depends on the extent to which the percentage of organ rejection is reduced. About one in ten currently fail, usually within the first four to five weeks.
Last October, Chris’ father David, 56, also a former military man, turned out to be a match. File photo of a doctor performing a kidney transplant
Regulatory T cells have caused a lot of excitement in transplantation medicine in recent years. A group of European doctors who recently tried them on liver transplant patients found that some were able to completely stop taking anti-rejection medications.
Chris Holmes, a former Army paramedic who served in Afghanistan, is one of more than 150 patients worldwide taking part in the study. While serving in the military, Chris, 31, fell ill with a condition called Enoch-Schonlein Purpura, which affects the skin and causes a blotchy rash — and can damage the kidneys. Initially, he took drugs that controlled the problem and continued his military career, leaving in 2020 to become a fitness trainer.
“Last year I looked in the mirror one day and noticed that I was quite bloated, when I’m normally quite skinny,” Chris says. “Doctors dropped a bomb – they told me my kidneys were failing and I needed a transplant.”
Chris had to deal with a grueling dialysis schedule three times a week – a treatment that takes over the function of the kidneys and filters waste products from the blood. His hopes for a transplant were dashed when his brother turned out not to be a good donor match. But last October, there was a breakthrough – his father David, 56, also a former military man, turned out to be a match.
In December, the transplant went ahead and just days later Chris received a 30-minute infusion of his own regulatory T cells, which had been extracted several weeks earlier and grown in the lab.
As a result, he has been able to lose weight to one anti-defensive pill a day instead of three and has gone back to work. In August he was even good enough to participate in the European Transplant Games in Oxford.
“I couldn’t bear the thought of losing the kidney my father gave me – if you touch wood, it will last for many years,” Chris says.
“We now have a special bond that is almost greater than the normal father-son relationship.”