End-stage renal disease is another name for kidney failure that is so advanced it can't be reversed. There are only two treatment options for patients experiencing end-stage renal failure -- dialysis or transplantation.

The National Kidney Foundation estimates that about 350,000 people in the U.S. have end stage renal disease and about 67,000 people die of kidney failure each year.

If a patient opts to have dialysis it may impose invasive limitations on his or her lifestyle because of the rigorous schedule, diet and side effects that accompany the treatment. A successful kidney transplant provides a better quality of life because it allows greater freedom and often is associated with increased energy levels and a less restricted diet.

There are two types of kidney transplants, one that uses a kidney from a living donor, and one that used a kidney from a deceased donor. Because of a shortage of donor kidneys, each year only a small percentage of people who need a transplant actually receive a kidney. The wait for a donor kidney can take years.

A transplanted kidney may not be an immediate fix as complications can be associated with the transplant surgery. The most important complication that may occur after transplant is rejection of the kidney. The body's immune system guards against attack by all foreign matter, such as bacteria.

This defense system may recognize tissue transplanted from someone else as "foreign" and act to combat this "foreign invader." Immune-suppressing drugs that prevent organ rejection are widely used to combat this complication; however they come with complications of their own. They raise the patient's risk for cancer and make them more susceptible to viruses and bacterial infections.

A new treatment being studied is showing promising results: preventing rejection without the need for immune-suppressing drugs. The treatment involves weakening the patient's immune system, then administering bone marrow from the donor along with the organ. When the patient's immune system reforms, it does so with the presence of both host and donor bone marrow cells, which teaches the immune system that both host and donor are "self."

In one experiment, four out of five kidney recipients were off immune-suppressing drugs up to five years later. The study involved five people who received kidneys from parents or siblings who had slightly different tissue types from the patients. Since many kidney transplant recipients and donors are similarly mismatched, there is hope more people might one day be spared from taking immune-suppressing drugs.

Researchers involved in the study say the next step is to take this trial to a larger population. They are also working on a procedure called xenotransplantation, the transplantation of organs from an animal to a human; in particular from a pig.

Additional Resources:
Massachusetts General Hospital & Harvard University School of Medicine
Transplantation Biology Research Center
MassGeneral.org/transplant
Interested study participants should call (617) 726-3706