In case renal failure severe chronic, the kidney no longer performs its functions and the patient needs replacement therapy: dialysis or a kidney transplant. To date in France 42,500 people are on dialysis and 33,700 have received a transplant.
But even after a successful operation, it happens that the patient’s immune system eventually rejects the transplanted kidney.
There are two types of rejection: acute and chronic. Acute rejection occurs quickly and the organ is rejected within a year. Chronic rejection takes longer and develops slowly over the years, ending in failure within 3 to 10 years of the transplant: the host’s immune system recognizes the new kidney as “foreign” and goes up an immune response against it, slowly destroying it. So after 3 years, 17% of kidney transplants fail.
Acute or chronic: rejection is the same
Researchers at the La Jolla Research Institute in California (USA), led by Professor Daniel Salomon, used gene expression to study acute and chronic rejection activity and check for similarities between patients whose bodies have rejected the transplant.
For this study, published in the American Journal of Transplantation, the team analyzed 324 kidney biopsies. They found that 80% of the genes expressed in acute rejection were shared in the tissues of kidneys that had suffered from chronic rejection.
“It is the same disease. Whether the rejection occurs in the month following the transplant or 5 years after does not change anything: the immune response is the same from a molecular point of view” explains Professor Salomon.
This study brings hope in the anti-rejection treatment of chronic transplant because it means that immunosuppressive drugs used for acute rejection could also be used for chronic rejection. In addition, Professor Salomon believes that these results are likely to be valid for liver, heart and lung transplants.
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