All of the patients in the study are alive, and 25, or 81 percent, remain off immunosuppression, one for more than seven years. Six of the patients in the study were weaned as part of a controlled protocol at the UPMC involving long-term adult and child transplant recipients. The others were withdrawn from their anti-rejection drugs -- either tacrolimus or cyclosporine -- because the immunosuppressants caused acute complications, including post-transplant lymphoproliferative disorder (tumors), viral and opportunistic infections and drug toxicity. These and other complications completely resolved after withdrawal of the drugs.
Close surveillance and prompt intervention is necessary to manage rejection and avoid graft loss, says Dr. Reyes. A total of 41 adults and children have been weaned off drugs as part of the University of Pittsburgh study.