At 54 years old, Miguel Ángel has spent practically his entire life depending on dialysis, forced to attend kidney therapy three times a week for five hours since he was 16 years old. Until this summer. This Barcelona patient at the Vall d’Hebron Hospital underwent a successful kidney transplant three months ago thanks to a new drug that opens a door of hope for all those who, like him, were considered almost “inoperable” due to their system hyperactivated immune system, which causes your body to reject the organ after going under the knife.
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“I have a new life”, summarizes, in a few words, Miguel Ángel. “Without dialysis, the most important thing is the freedom you gain. For decades, in which he has also undergone two unsuccessful transplants, his life has been glued to the dialysis machine every two days, which conditions everything from vacations to job search. “It’s an obligation that, if you don’t fulfill, you can die,” he recalls. Now a new perspective opens up for him in which the main hindrance, he says, will be to strictly comply with the medication.
The operation has been carried out by the Vall d’Hebron Renal Transplant Unit using an experimental drug, called imflimidase, and it is expected that another 50 patients in different centers in Europe will participate in this study, all of them with immunological characteristics such as Michelangelo’s, which make it practically impossible to find a compatible donor. The clinical trial is currently in the stage prior to approval by the European Medicines Agency.
Oriol Bestard, Head of Nephrology at the Hospital, celebrated the results of the operation and recalled that currently between 10% and 15% of the 900,000 people on the waiting list in Catalonia for a kidney transplant have this immune response , often caused by previous contact with other tissues, due to previous transplants or pregnancies (in the case of women). Bestard recalled that transplantation, compared to dialysis, not only improves the “quality” of daily life for patients, but also “provides better survival” and, furthermore, is a cheaper process than treatment.
The key to this drug is that it is an enzyme that breaks immunoglobulins in half and causes those patients who have many antibodies to keep none. This effect lasts between four and seven days, according to the head of the Nephrology Transplant Unit section, Francesc Moreso. During those days the transplant can be carried out “with the certainty that rejection” of the organ will not occur, he explained. From there, the antibodies are produced again, adds Bestard, but by then the patient is “under treatment with other immunosuppressants that can modulate his immune system in the short and medium term,” he continues.
“There are patients who have been receiving dialysis for three or four decades and who have not been able to benefit from a successful transplant,” Moreso explained, despite the fact that many of them are included in “prioritization” programs if a compatible donor is found. . This study, the Vall d’Hebron doctors have expressed, is also a hope for other types of transplants. “It can be beneficial for many diseases, there are already several studies in progress,” Bestard ventured.
Miguel Ángel had been on dialysis since 1984 due to a malformation in the urinary tract that caused terminal chronic renal failure. After undergoing surgery twice during the 1990s, his immune system was left “highly sensitized,” with antibody levels too high to match donors. In May, however, his life took a turn when he received treatment with this drug. “As chance would have it, in the morning I signed the consent to participate in the study and in the afternoon they called me to have the transplant.” Now this Barcelonan, computer scientist by profession, continues in outpatient treatment, but without the need to undergo dialysis.