A recent early-stage clinical trial conducted by researchers at the University of Pittsburgh School of Medicine has shown promise in the field of living donor liver transplants (LDLT). The study, reported in Science Translational Medicine, explores a novel approach that could potentially free transplant recipients from the long-term use of immunosuppressant medications, which often come with severe side effects.
In this Phase 1 trial, 15 patients scheduled to undergo LDLT received an infusion of immune cells derived from their living donors about a week before the transplantation. The research team, led by senior author Angus W. Thomson, separated monocytes from the donor’s blood and induced them to create regulatory dendritic cells (DCregs), a type of immune cell crucial for distinguishing foreign invaders from healthy tissue.
Despite the short lifespan of the transplanted DCregs, they managed to produce exosomes, tiny particles that facilitate cellular communication. These exosomes appear to condition the transplant recipients’ immune systems to recognize the donor’s cells as safe, potentially reducing the need for long-term immunosuppressant drugs.
The trial aimed to assess the feasibility and safety of this approach, and the results indicated that it can be seamlessly integrated into the transplantation process without compromising safety. There were no notable differences in safety between the patients who received the DCreg infusion and those who followed the standard immunosuppressant treatment protocol.
Furthermore, a year after the transplants, the patients who received the DCreg infusion exhibited a reduction in immune cells that typically signal a negative response to the transplanted liver. This reduction has been shown in animal studies to enable a gradual reduction in immunosuppressant medications.
The team plans to continue monitoring the trial participants and anticipates reporting additional results in the near future. If successful, this approach could significantly benefit the transplantation community by reducing the long-term dependency on immunosuppressants and their associated side effects.
Source: University of Pittsburgh