New alternative to immunosuppressive treatment after kidney transplants without severe side effects

Aug 3 2011

There is now a new alternative to immunosuppressive treatment after kidney transplants which comes without the usual severe side effects. The Medical University was significantly involved in the clinical development of the active ingredient Belatacept and a suitable preparation has now been given EU-wide authorisation.

"This could fundamentally revolutionise kidney transplantation and its treatment", says Ferdinand Mühlbacher, director of the University Department of Surgery and together with the immunologist Thomas Wekerle, head of the Viennese study centre. Instead of nine years, a transplanted kidney supported with Belatacept can last 13 years according to conservative estimations. Mühlbacher is somewhat more optimistic. "I estimate 15 to 17 years." Nine out of 22 patients are still involved in the Vienna scientist's long-term study. They are being treated with the substance ten years after a transplant. "Their kidney functions are excellent", says Mühlbacher.

The advantage of the co-stimulation blocker Belatacept is easily explained as contrary to the usual immunosuppressants, the calcineurin inhibitors such as ciclosporin for example, Belatacept does not have any side effects. For almost 30 years calcineurin inhibitors have been used for the life-long suppression of the immune system's undesired reactions following organ transplants. The possible side effects such as high blood pressure, diabetes or lipid metabolism disorders used to have to be considered. Mühlbacher says, "However we now have a substance which is as effective, which is not toxic, which does not have any side effects, and which ensures better organ function." With transplants there is still the fundamentally increased risk of cancer which according to Mühlbacher is as high with the active ingredient Betalacept as with the calcineurin inhibitors.

Around 420 transplants are performed at the MedUni Vienna each year and 180 of these involve kidneys. "We shall of course not now change all of our patients to the new medicine, however we shall of course consider this for new patients", says Mühlbacher.

MedUni Vienna has had a great reputation in transplant medicine since 1990

The significant proportion of the clinical development of this active ingredient also underlines the Medical University of Vienna's expertise in transplants which it has acquired over decades. "Our reputation in transplant medicine can be attributed to the astronomical numbers of donors in the 1990s", says Mühlbacher. "In 1990 only there were 260 kidney patients." As a result of the successful transplants there was a positive "yo-yo effect" which led to increasing numbers of donors and also to an increased reputation and international regard. In 2013 the European Transplant Congress shall take place in Vienna, and Vienna was the venue of the 20th World Congress of the Transplantation Society in 2004.

Kidney and liver transplants are already commonplace these days, says Mühlbacher, and the current trend is for lung transplants. The Medical University of Vienna is also a world leader in this field. Walter Klepetko, Chairman of the Department of Thoracic Surgery, leads the largest lung transplant centre in Europe, which is also the second largest in the world.