Drug-Free Organ Transplant Tolerance: Todd Painter

For 10 years, primary sclerosing cholangitis, a progressive liver disease, left Todd Painter weak and sleepless. His life consisted of working at Southwest Airlines and fighting insomnia as he tried to rest for the next day.

Todd describes his liver transplant at Baylor as the procedure that gave him back his life. Upon awakening in the recovery room, he immediately felt better. Unlike most organ recipients, Todd does not have to take the steroids that prevent organ rejection but sometimes have potentially harmful side effects. Instead, Goran Klintmalm, M.D., Ph.D., and his transplant team on the medical staff at Baylor used an advanced experimental drug protocol to reboot Todds immune system by selectively weakening it and then allowing it to rebuild with his new liver in place. It accepts Todds new liver as his, not a transplant.

It feels great after 10 years to finally live a normal life again; I feel so grateful. Ive rediscovered traveling and the joy of simply being outdoors. Plus, Im able to sleep soundly for the first time in 10 years.

Patients needing organ transplants face not only donor organ scarcity, but also increased risks of hepatitis C, diabetes and hypertension all side effects of corticosteroid anti-rejection drugs most transplant recipients take for the rest of their lives. Goran Klintmalm, M.D., Ph.D., and the transplant team on the medical staff at Baylor hope to change that. They are engaged in a clinical trial that uses a new protocol to create a natural immune system tolerance for a transplanted organ. In the experimental protocol, most of the patients immune system is destroyed by administering specialized drugs prior to transplantation.

Then, as the system rebuilds itself with the new organ in place, it may learn to accept the new organ as if it were original equipment. The patient takes only a small dose of one non-steroidal anti-rejection drug whose dosage physicians slowly reduced to zero. The potentially harmful corticosteroids that have been used in virtually all organ transplants for decades may be able to be avoided altogether. By alleviating the causes of organ failure that can result in a second transplant, the protocol may reduce the demand for donor organs.