Revolutionary Cell Therapy May Eliminate Need for Immunosuppressants in Liver Transplant Recipients

Donor immune cells may reduce or eliminate the need for immunosuppressants in liver transplant recipients, potentially revolutionizing post-transplant care, according to a study published in Science Translational Medicine.

Researchers have found that administering a treatment made of donor immune cells to patients 1 week before receiving a live-donor liver transplant is both safe and feasible. They analyzed data from 53 participants who underwent this innovative procedure.

“Thirteen patients were given a single infusion of donor-derived DCreg 1 week before transplant (STUDY) and were compared with 40 propensity-matched standard-of-care (SOC) patients,” explained Lillian Tran, Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh School of Medicine in Pittsburgh, PA, USA, and coauthors.

One year after the liver transplants, the results were promising. Patients who received the cell therapy showed similar control of graft rejection compared to those who received standard care. Importantly, they also exhibited lower levels of cytotoxic T cells and natural killer cells, which are typically involved in organ rejection.

“Analysis of 12M allograft biopsies revealed lower frequencies of graft-infiltrating CD8+ T cells, as well as attenuation of cytolytic TH1 effector genes and pathways among intragraft CD8+ T cells and NK cells, in DCreg-infused patients,” explained the study authors.

This downregulation of immune response suggests that patients who receive this treatment can reduce their dosage of immunosuppressant drugs or stop taking them altogether without rejecting the transplanted liver. This is a significant development, as long-term use of immunosuppressants can lead to serious side effects, including increased risk of infections and certain cancers.

Reference

Harris E. Donor immune cells may reduce or eliminate need for immunosuppressants. JAMA. 2023;330(18):1724. doi:10.1001/jama.2023.20635

Tran LM, Macedo C, Zahorchak AF, et al. Donor-derived regulatory dendritic cell infusion modulates effector CD8+ T cell and NK cell responses after liver transplantation. Sci Transl Med. 2023;15(717):eadf4287. doi:10.1126/scitranslmed.adf4287