A simple, inexpensive blood test could soon help doctors halt organ rejection before it impairs transplanted hearts and kidneys.
"In the past, we couldn't spot rejection episodes until they harmed the organ," said Atul Butte, MD, PhD, who is co-senior author of the new research and an associate professor of medical informatics and of pediatrics at the Stanford University School of Medicine, in addition to director of the Center for Pediatric Bioinformatics at Lucile Packard Children's Hospital. "Our goal is to develop blood tests that will keep transplanted organs functioning so that patients can avoid a second transplant."
Butte and his collaborators have made a big step toward that goal. The Stanford team found three easily measured proteins that rise in the blood during acute rejection, in which a patient's immune system attacks his or her transplanted organ. The research, which will be published online Sept. 23 in PLoS-Computational Biology, is the first-ever report of an immune-rejection signal that is shared by two kinds of transplanted organs. The protein signals are now being validated in liver- and lung-transplant recipients as well.
The new blood test circumvents the invasive, expensive, slow system now used to keep tabs on transplants. Currently, all organ recipients receive functional monitoring of their new body parts. Heart transplant patients get regular echocardiograms, for instance. If organ function drops, doctors cut a tiny sample from the transplanted tissue to check for rejection, and then adjust patients' immune-suppressing drugs accordingly. About 25 percent of kidney recipients and 40 percent of heart recipients experience an episode of acute rejection in the first year after transplant.