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- MEDICINE, Page 77Lifesaver
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- A new drug may improve the odds for successful transplants
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- The 12,000 organ transplants performed in the U.S. each
- year are often successful only because the patients take a daily
- dose of cyclosporine. The drug keeps their immune systems from
- attacking and rejecting the foreign organs. But it is not
- perfect. Some 70% of patients getting a new liver, for example,
- still suffer rejection episodes. And many organ recipients face
- life-threatening side effects from cyclosporine, including an
- increased risk of cancer and heart disease.
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- Now a respected researcher who was one of the first to use
- cyclosporine may have found a better way to make transplants
- succeed. Dr. Thomas Starzl of the University of Pittsburgh, the
- world's largest transplant center, is expected to report in the
- British journal Lancet this week that a new drug, FK-506, is
- proving to be more powerful and less toxic than cyclosporine.
- In more than 100 patients taking FK-506 for up to eight months,
- the rate of organ rejection was only one-sixth as high as in
- those using cyclosporine. Side effects were minimal, though
- long-term consequences remain unknown. The Food and Drug
- Administration calls the preliminary research "very exciting,"
- but approval for general use may be years away.
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- FK-506 works by suppressing the proliferation of certain
- white blood cells, the workhorses of the immune system. Starzl
- thinks the drug could signal a revolution in organ
- transplantation. Moreover, it could possibly lead to a treatment
- for diseases, like arthritis, that are caused by an overactive
- immune system.
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- Manufactured by Fujisawa Pharmaceutical of Osaka, FK-506 is
- derived from a soil fungus found in Japan. Starzl first learned
- of the drug in 1986 at a meeting in Helsinki. Other researchers
- had dismissed it because in studies using dogs it caused severe
- bleeding and other problems. But Starzl believed the reaction
- occurred in dogs alone and undertook a graduated series of
- experiments on several other animals, from rats to baboons.
- These tests were encouraging, and in February 1989 Starzl tried
- the drug on Robin Ford, a 26-year-old secretary who was in
- danger of rejecting her third liver. After two weeks of FK-506
- treatments, she recovered completely. Says Ford: "It's
- incredible how great this drug is."
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- But FK-506 will not remove the most serious hurdle to
- transplants: the chronic shortage of donor organs. More than
- 18,000 Americans in need of transplants are waiting for organs
- to become available.
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