Minimization of Anti-Rejection Medication

Seattle Children's Hospital's intestine transplant team is working to find the balance between prescribing anti-rejection medications and preventing infection in the newly transplanted organ.

Because the intestine is very prone to rejection, children who have an intestine transplant must take an aggressive regimen of anti-rejection medication. However, because anti-rejection medications suppress the body's immune system, they make the intestine prone to infection. A high level of anti-rejection therapy can often lead to more intestinal complications due to infection.

As we learn more about the immune system, we find that a child's body needs a certain amount of reaction against a new organ to "get used" to it. Overwhelming the body with drugs that suppress the body's natural immune response can be counterproductive.

Dr. Jorge Reyes, director of Transplant Services, has been at the forefront of studies to reduce the amount of anti-rejection drugs in intestine transplant patients.

A study by Dr. Reyes and other transplant researchers at the University of Pittsburgh's Thomas E. Starzl Transplantation Institute, where Dr. Reyes worked until summer 2004, showed that a non-steroid anti-rejection regimen was very promising for intestine transplant and other solid-organ transplant surgeries.

In the study, patients received the standard anti-rejection drug tacrolimus after transplant, but they did not receive steroids. Tapering off tacrolimus was attempted after 120 days.

Seattle Children's Intestinal Care Program plans to conduct and participate in many clinical and laboratory research projects to address intestinal failure, liver disease associated with total parental nutrition (TPN) and intestine transplant.

Combined Organ Transplants

Diseases that lead to intestinal failure often affect other organs. Also, TPN and intravenous nutrition, while lifesaving therapies, can lead to liver failure. As a result, some candidates for intestine transplant need multi-organ transplants.

Seattle Children's Transplant Center performs multi-organ transplants under the expert direction of Dr. Reyes, who has performed more than 200 of these procedures, including intestine-liver and heart-lung transplant.

As one of the pioneers in intestine transplant, Dr. Reyes' presence at Seattle Children's exemplifies our commitment to creating one of the most robust programs for intestine and multi-organ transplant in the United States.