Researcher Hopes to Reduce Lung Transplant Rejection

Research Matters, Breathe Easy news magazine, Fall 2001/Winter 2002

GAIL KAIN HAS A NEW LEASE ON LIFE. The 54-year-old Fresno woman received a lung transplant six months ago, but now she is hoping the drugs she is taking will fight off the first signs her body is rejecting the transplanted lung.

If John Belperio, MD, has his way, lung transplant recipients like Kain won’t ever have to face the prospect of rejection. The researcher, who works in the Division of Pulmonary and Critical Care at UCLA Hospital, is investigating how white blood cells operate during rejection in an effort to find a way to stop their attack on the transplanted lung. The American Lung Association of California is funding his research, in part, through its research program.

Lung transplants are currently prescribed for people of all ages with life-threatening lung diseases such as emphysema, cystic fibrosis, pulmonary fibrosis and pulmonary hypertension. A reported 956 lung transplants were performed in 2000.

The transplant community is joined under one nationwide umbrella called the United Network for Organ Sharing (UNOS). Based in Richmond, Virginia, the nonprofit organization maintains the nation’s organ transplant list. Today, more than 3, 400 people are waiting for lung transplants. For more information about UNOS, call 888.894.6361 or visit www. unos. org.

Kain has "inherited emphysema, " also known as alpha-1 antitrypsin deficiency, a rare condition caused by a genetic defect that prevents the body from making a protein (alpha-1 antitrypsin)that protects lung tissue. She was diagnosed in 1991 and by 1999 the disease had progressed to the point where Kain wouldn’t make it without a transplant.

Lung Transplant Recipients Face Higher Rejection Rates

Lung transplant recipients like Kain get frequent checkups after surgery because the risk of rejection and infection is much higher for lungs than for other transplanted organs. At a recent visit, Kain was told her new lung was showing signs of rejection and she was immediately put on steroid medications to stop it.

"Unfortunately, rejection is a natural host response, " says Dr. Belperio. "The white blood cells attack the newly transplanted lung as it would any other foreign material. It’s a function of the body to protect itself. "

More than half of lung transplant recipients will face chronic rejection within the first 18 months, according to the researcher. This high rate of rejection is part of the reason five-year survival rates for lung transplant recipients is less than 50 percent while survival rates for heart, kidney and liver recipients is higher than 70 percent.

Dr. Belperio is examining a set of proteins that are present during rejection to determine whether they can be manipulated in a way that would stop the rejection process, and maybe even prevent it from ever happening. He is hoping that someday transplant recipients will be given a pill that would wipe out any possibility of rejection. "That would be wonderful, " Kain says.