Health Alert: Finding the right anti-rejection dosage for transplant patients

NATIONAL - It's hard to protect children under five from rejecting a transplanted liver because of their small body size and immature immune system. But now there are efforts to predict this potentially dangerous complication.

Renee Rosner remembers her daughter's struggle, "Around Adelynn's fourth week after birth she was still very jaundiced, so we went to the doctor, and um, they ran some blood tests and found out her bilirubin was very high."

Adelynn had a condition that was damaging her liver. Rosner says, "Fortunately, she did very well for several months, and was able to gain some weight and become much stronger by the time she needed her transplant."

Anti-rejection medicines are part of the equation after transplant to keep patients healthy, but doctors are still trying to find the right balance.

Pediatric transplant surgeon Rakesh Sindhi says, "Where the drugs fail, they fail either because we're over-doing it, or we're under-doing it."

Resulting in rejection, if too little medicine is used, or cancer, if the dose is too high.

To decipher this puzzle, transplant researchers at the Children's Hospital of Pittsburgh are poring over genetic clues.

Sindhi says, "We're trying to establish fingerprints, so-called genomic fingerprints, that will tell us that this person is going to be at risk for rejection."

They're focusing on so-called polymorphisms, or mistakes in DNA code. Sindhi says, "We can measure up to about, or characterize up to about half-a-million of the 12 million known mutations, and we try to characterize them not just in children, but in parents."

And by sifting through these clues, they hope to understand which genes cause problems, ultimately helping doctors personalize the medicine transplant patients rely on.

Doctor Sindhi says the information from this study should help ensure anti-rejection medicines are prescribed at the right dose - less for patients with a better tolerance for the organ, and more for those with a greater risk of rejection.

Posted by Chantelle Janelle