Biopsies Save Transplant Patients?


PHILADELPHIA, PA. (Ivanhoe Newswire) — Organ transplant patients can wait up to seven years for a matching donor ,and even then, the ten year survival rate is only about 57 percent with some transplants. Now, scientists are diagnosing problems much earlier through a blood biopsy.  A simple blood test provides critical information to extend patients’ lives.

Heart and lung transplant patients can go through 12 to 15 invasive surgical biopsies in just a few years.

“We do this because we have no good way of doing surveillance on our patients,” Prashanth Vallabhajosyula, MD, MS, Assistant Professor of Cardiovascular Surgery at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania, told Ivanhoe.

With a simple blood draw, doctors look for exosomes, tiny packets released by cells into the bloodstream. They carry molecular information that could indicate early signs of organ rejection.

Dr. Vallabhajosyula explained, “It turns out these exosomes can be picked up that are released by these transplanted organs and more importantly, their profile seems to change very early on in the rejection process, which for us is very critical.”

That’s because the exosomes carry proteins that are identical to the cell releasing them. Doctors then analyze that genetic code, which provides a biomarker of the patient’s progress.

“If we can have a blood test that can work as the first line of assessment and surveillance, and then follow up with a biopsy if there is any suspicion it would make a huge difference.” Dr. Vallabhajosyula stated.

It could mean increased quality of life for the patient, as doctors look deep inside the genetic makeup of the cells.

“What’s inside is like a postcard that conveys the state of the organ. The cells in the organ- whether they’re happy, whether they’re under stress, or whether they’re under attack,” Ali Naji, MD, PhD, J. William White Professor of Surgery at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania told Ivanhoe.

Elements that will let doctors monitor any organ, without additional surgery.

More than 30,000 transplant surgeries are performed each year in the U.S. The PENN doctors say the early detection by blood biopsy could enable doctors to keep transplant recipients healthier, if further studies confirm this particular approach.

Contributors to this news report include: Cyndy McGrath, Supervising Producer; Donna Parker, Field Producer; Gabriella Battistiol, Assistant Producer; Roque Correa, Editor; Kirk Manson, Videographer.

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REPORT:       MB #4271

BACKGROUND: A person may need an organ transplant if one of the organs has failed due to an injury or illness. The organs that can be transplanted are the heart, intestine, kidney, liver, lung, and pancreas. The wait for an organ transplant can be a long one; a doctor must match the donor to the recipient to reduce transplant rejection. Since there are so many people seeking transplant surgery, there may also be a long waitlist for a good match. After the transplant is completed, a person may have restrictions to their daily routines, and could be prescribed medication they must take for the rest of their lives to keep their body from rejecting the new organ.

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STANDARD TREATMENT: After transplant surgery, immunosuppressants are given to the patient. Side effects may include nausea and vomiting, diarrhea, anemia, hair loss or unwanted hair growth, weakened bones, and high blood pressure depending on how the body responds to these medications. In addition, more medication is given to cope with immunosuppressants. These include antibiotics, anti-ulcer medications, and possibly diuretics. With so many drugs being taken, one must be careful with other drug interactions and possibly even food or drink interactions. If the body rejects the transplant, signs that indicate this will include; pain at the site of the transplant, feeling unwell, crankiness, flu-like symptoms, swelling, weight changes, change in heart rate, and urinating less often. If the organ transplant is rejected, that means that the medication needs to be adjusted for the organ to work well again.  Rejection doesn’t have to happen immediately after surgery; it can also occur years later.

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NEW TECHNOLOGY: Biopsies have now been proven to show early detection of rejection. The early detection can prevent irreversible damage to the transplanted organs. When a heart biopsy is done for example, a small tube has to be threaded into the jugular vein of the neck to gather samples of heart tissue. The procedure is painful, can cause abnormalities to the heart, and is expensive, but it can give medical experts the information they need to prevent further damage should the body be prone to rejecting an organ. According to researchers, a set of genes in the blood can pick up inflammation and acute rejection in organ transplants without the need of an invasive biopsy. The blood draw doesn’t just work for heart transplants, but for other organ transplants as well.

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Abbey Anderson


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Doctor Q and A

Read the entire Doctor Q&A for Prashanth Vallabhajosyula, MD, MS

Read the entire Q&A