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SUMMER 2006
Transplant Research
Transplants in HIV-positive Patients
UCSF transplant surgeon Peter Stock, M.D., Ph.D., leads a multi-center NIH grant, examining the safety and efficacy of liver and kidney transplantation in HIV-positive patients. It is a pressing issue, given that most HIV-infected individuals no longer die from progression of HIV to AIDS, Stock said. Highly active anti-retroviral therapy (HAART) has made HIV infection a chronic disease.
When patients die, it is from comorbid conditions such as liver failure caused by hepatitis B or C infection. HIV-induced kidney failure is also a life-threatening problem, particularly among African Americans.
Early results in transplanting HIV-positive patients are encouraging, Stock said. UCSF has performed more than 40 transplants in HIV-positive patients since 2000. Patients must respond well to HAART therapy to be candidates for transplantation.
As part of the NIH grant, researchers in laboratories across the country are looking at how immunosuppression affects HIV-positive patients. They are examining not only graft rejection, but how the patient's immune response changes towards HIV and other co-pathogens such as hepatitis B, hepatitis C, cytomegalovirus and human papilloma virus, which are frequently associated with HIV.
Transplanted Tissue
The immune system's rejection of foreign tissue remains a major stumbling block to the long-term success of organ transplantation.
Working in mice, researchers in the lab of transplant surgeon Sang-Mo Kang, M.D., are studying ways to genetically modify donor dendritic cells so that they can specifically eliminate the T cells that cause rejection.
Their goal is to inactivate the immune system's response to a transplanted organ, while retaining its ability to combat infections and cancer. Such donor-specific tolerance would eliminate the serious side effects associated with the long-term use of immunosuppressive medications, which are currently needed to manage organ rejection. Kang's team also is working to define the fundamental mechanisms of transplant rejection and tolerance.
 
Summer 2006 Table of Contents
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