Posted by Left-e on yahoo recently There's an interesting report out today that the porcine heart which was transplanted at UMd into Mr. David Bennett may have been infected with a cytomegalovirus. Mr. Bennett died about 2 months after the historic transplant. Experts are trying to sort out to what extent the previously undetected infection may have contributed to Mr. Bennett's death, but it is well established from baboon experiments that porcine hearts contaminated/infected with CMV have a much shorter time to rejection or death following transplant. I find this news quite interesting given the case report @Tim posted a couple of months ago. In that case Dr. Lightner treated a patient suffering from acute rejection of his intestinal graft. She obtained FDA approval to treat the patient with remestemcel-L on an emergency basis. That patient was also suffering from a viral infection in his lungs – either cytomegalovirus or Epstein-Barr virus (or both). The viral pneumonia prevented the use of high dose steroids, which would have been standard of care to treat the rejection. From Dr Lightner's report: “Within 24 h of intravenous remestemcel-L delivery, the patient was weaned off supplementary oxygen support and remained off for the remainder of the hospital admission.”So, a dramatic response of the pneumonia to IV rem-L and the patient subsequently received rem-L via endoscope to “mop up” recalcitrant areas of intestinal inflammation due to the rejection process. Dr. Lightner concluded her case report with this intriguing statement (all-caps emphasis added): “...the authors felt it was important to highlight MSCs as a upotential therapeutic agent for patients who present with allograft rejection IN THE SETTING OF CONCURRENT INFECTIOUS COMPLICATIONS”. Organ transplant patients are chronically immuno-suppressed to prevent rejection of the foreign organ. As a result they are susceptible to viral, bacterial and fungal infections. When there's simultaneous infection and rejection – as in the case of Dr. Lightner's patient and now we're learning probably in the case of Mr. Bennett – treatment options are limited... because any treatment for the rejection risks making the infection worse and altering immune suppression to treat the infection risks making rejection worse. These patients are between the proverbial rock and a hard place. We can only wonder whether Mr. Bennett's course may have been improved with an emergency infusion of rem-L bringing both anti-infectious and anti-rejection/anti-inflammatory properties to bear at the same time in just the right balance as only living cells can do. that the porcine heart which was transplanted at UMd into Mr. David Bennett may have been infected with a cytomegalovirus. Mr. Bennett died about 2 months after the historic transplant. Experts are trying to sort out to what extent the previously undetected infection may have contributed to Mr. Bennett's death, but it is well established from baboon experiments that porcine hearts contaminated/infected with CMV have a much shorter time to rejection or death following transplant. I find this news quite interesting given the case report @Tim posted a couple of months ago. In that case Dr. Lightner treated a patient suffering from acute rejection of his intestinal graft. She obtained FDA approval to treat the patient with remestemcel-L on an emergency basis. That patient was also suffering from a viral infection in his lungs – either cytomegalovirus or Epstein-Barr virus (or both). The viral pneumonia prevented the use of high dose steroids, which would have been standard of care to treat the rejection. From Dr Lightner's report: “Within 24 h of intravenous remestemcel-L delivery, the patient was weaned off supplementary oxygen support and remained off for the remainder of the hospital admission.”So, a dramatic response of the pneumonia to IV rem-L and the patient subsequently received rem-L via endoscope to “mop up” recalcitrant areas of intestinal inflammation due to the rejection process. Dr. Lightner concluded her case report with this intriguing statement (all-caps emphasis added): “...the authors felt it was important to highlight MSCs as a potential therapeutic agent for patients who present with allograft rejection IN THE SETTING OF CONCURRENT INFECTIOUS COMPLICATIONS”. Organ transplant patients are chronically immuno-suppressed to prevent rejection of the foreign organ. As a result they are susceptible to viral, bacterial and fungal infections. When there's simultaneous infection and rejection – as in the case of Dr. Lightner's patient and now we're learning probably in the case of Mr. Bennett – treatment options are limited... because any treatment for the rejection risks making the infection worse and altering immune suppression to treat the infection risks making rejection worse. These patients are between the proverbial rock and a hard place. We can only wonder whether Mr. Bennett's course may have been improved with an emergency infusion of rem-L bringing both anti-infectious and anti-rejection/anti-inflammatory properties to bear at the same time in just the right balance as only living cells can do.
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