Kidney failure, a cause for concern

Chennai, Oct 12: The growing incidence of kidney failure and the reducing life span of the transplanted organ is causing concern among patients suffering from renal problems, according to an expert.

The lifespan of patients undergoing dialysis has also come down and worse, less than ten per cent of renal failure patients can really afford it, according to Dr Palani Ravichandran, Head of Nephrology, Transplantation and Kidney Diseases Department in Institute of Organ Transplantation (KIOT) of St Thomas Hospital here.

The life of a transplanted kidney was between five to ten years and patients returned to dialysis after this or searched for another donor due to chronic allograft nephropathy.

Lymphocytes, the most important of the immune cells, attack the new kidney cells damaging the transplanted organ in the process.

Drugs and infection also cause major damage leading to failure of the transplanted kidney.

Global research on a new kind of cells in the immune system has shown to bring a new hope for the transplant patients.

Dr Ravichandran had successfully launched herbal dialysis and developed the novel combination therapy for preventing rejection of a transplanted kidney and made a high-risk patient into a low risk individual.

Dr Ravichandran said it was found a few patients who survived for ten or more years after kidney transplantation developed 'tolerance.' This was because the body had new type of cells called T regs or immune regulatory lymphocytes which were effective in preventing damage to kidneys when their count is increased. This helped in prolonging the life of the tranplanted organ.

Research efforts were directed at increasing these cells. This was currently done by combination therapy using different types of monoclonal injections that target specific immune cells so as not to disturb the regulatory cells.

Once the lymphocytes were depleted the already present antibodies were also reduced by a new method called Double Filtration Plasmapheresis and Splenic Radiation.

To prevent infection due to low immunity, the patient was infused with donor stem cells which were allowed to grow post-operation in such a way they turned into tolerant cells and protected the new kidney cells from being destroyed. They also helped replace damaged cells.

This prolonged the life of transplanted kidney by preventing rejection, not developing infection as drugs needs are very low and not using drugs that damage the kidney like cyclosporine and steroids, Dr Ravichandran claimed.

The patients are monitored by the development of antibodies in the blood periodically by a most advanced test called anti-HLA antibody test for Class I and Class II antigens to make sure the damaging lymphocytes do not come back.

He also pointed out to the research work presented in scientific fora at World Transplant Congress in Boston (USA) and Berlin (Germany) and European Transplant Society Congress at Switzerland recently.

The research papers will be published in the prestigious journal International Immunopharmacology in the coming month. Many centres had shown interest in learning more on the new technology which was very useful to poor patients, especially those who could not afford costly post-operative medication, Dr Ravichandran claimed.

UNI