Drug-Free Hope For Transplants

Jennifer Duran, Dec. 12, 2005, transplant patient transplants
Jennifer Duran knows a bit about how challenging life will be for the French woman who got a face transplant.

After a kidney transplant at age 13, Duran took "20-something pills a day" to keep her body from rejecting her new organ. The drugs' side effects included facial hair — "not a good thing when you're a 13-year-old girl" — and memory problems that linger to this day.

The worst was the warts on one leg and foot, so painful that as a college student she often couldn't walk.

But today Duran, 26, is the picture of hope to many transplant patients. Her first donated kidney was replaced by a second one in 2002, along with a promising experimental treatment. Now she doesn't take any of the anti-rejection drugs the French woman will likely take for life.

"For the first time in my life, I know what healthy is. I'd never known that before," said the Boston area librarian.

Duran is the shining example of a risky approach: Doctors killed off her entire immune system and gave her bone marrow from her organ donor before she got the new kidney. The bone marrow stem cells gave her a new immune system that doesn't try to reject her donated organ.

"I'm very excited. It's still fairly new, but if it continues to work as well as it has so far, I think this could benefit a lot of people," said Dr. David Sachs, an immunologist at Massachusetts General Hospital.

He's tried the experimental technique on four patients and been successful with three, including Duran. One of his successes is a grandmother in her 60s who's been living without anti-rejection drugs for seven years.

But other doctors view the technique as too dangerous to use in all but the most urgent cases.

"Many people wouldn't survive the regimen," said Dr. Hans Sollinger, a professor of surgery and chairman of transplantation at the University of Wisconsin-Madison. "The regular (transplant) surgery is a walk in the park compared to this — it's much too toxic right now."

In Duran's case, however, the new procedure gave her a new life. Duran, whose kidneys began to fail at an early age, is believed to be the only person in the world to undergo both a standard kidney transplant and a second kidney transplant that also included a bone marrow cell injection.

The woman in France who became the first in the world to get a partial face transplant is getting a similar experimental treatment, but details of it are unclear, and Sachs and other doctors are skeptical of it based on what they have read.