A “reprogrammed” immune system, thanks to a stem cell transplant from her mother, means an eight-year-old girl in Britain is spared the ordeal of taking lifelong drugs to stop her body rejecting her kidney transplant.
The UK-first “reprogramming” procedure means her body has accepted a donor kidney as its own, clinicians said.
Because the bone marrow transplant and kidney came from the same donor – her mother – the new kidney is functioning without the need for drugs that stop the body from rejecting the donated organ.
The Independent reports that while providing a vital function after transplant surgery, immune-suppressants work by dampening down the body’s immune system, meaning anyone taking them is at higher risk of an infection, among other complications.
They usually need to be taken for life but Aditi Shankar stopped taking the drugs a month after her surgery, thanks to the pioneering work by doctors at Great Ormond Street Hospital (Gosh) in London.
Her mother said she was “happy and proud” to donate both bone marrow and one of her kidneys to her daughter. The girl is now able to swim, sing, dance and play on her trampoline, after spending much of her time last year in and out of hospital receiving dialysis.
Aditi was first referred to Gosh when she was five and doctors discovered she had a rare genetic condition called Schimke’s immuno-osseous dysplasia, which affects the immune system and kidneys.
For every 3m children in the UK, doctors are likely to only find one case.
The first treatment on offer was dialysis and the child had to travel into central London for treatment at least three times a week.
In March 2021, her kidney function dropped drastically but a kidney transplant was not possible while her immune system was so weak.
So the renal, immunology and stem cell transplant teams at Gosh worked with international colleagues to devise a treatment plan.
For four weeks, Aditi was on the intensive care unit undergoing her bone marrow transplant while having dialysis 24 hours a day.
Six months later, in March 2023, she was well enough for the kidney transplant.
Professor Stephen Marks, children’s kidney specialist at Gosh, said: “I lead the kidney transplantation programme at Great Ormond Street Hospital and have worked here for more than 25 years and she is the first patient in the United Kingdom – who has had a kidney transplant – to not require immunosuppressive medication after the surgery.
“Her underlying immune condition meant she would not be able to receive a kidney transplant, so her immune deficiency had to be corrected by having mum’s bone marrow first, and because she was able to accept her mum’s bone marrow, that therefore meant her body could then see her parent’s kidney as being part of her.
“A month after the transplant, we were able to take her off all of her immunosuppression, meaning she doesn’t get the side effects of the drugs.”
She is the first patient in the UK, and the first patient under the National Health Service, to have had a kidney transplant for this condition and to be off immunosuppression within a month.
Marks will present details of the case to the European Society for Paediatric Nephrology conference next week. An editorial detailing the findings is also due to be published in the journal Paediatric Transplantation.
See more from MedicalBrief archives:
New cell therapy prevents immunosuppression-related side effects
Kidney transplant drug halves risk of early rejection