Life from Life

Posted:  11/29/2018

 

If you have ever read Mary Shelley’s 1818 novel, Frankenstein, or seen any of the movies based on it (including such gems as Abbot and Costello Meet Frankenstein), you at least know that the book is about a scientist, Dr. Frankenstein, a well-educated idealist who created life.  Only in this case, it regrettably took the form of a horrible monster.

Of course, Frankenstein was just science fiction, and the scientific knowledge came from what was known in the early 1800s, a relative stone age compared to where we are today.  And yet, even with all our advancements, we are not able, as Dr. Frankenstein did, to create life from non-life.  Outside of some successful research in creating simple microbes, we are not even close.

However, the miracles of modern science have allowed us to share life; that is, to take from the life within us and give it to others who need it. We are of course talking about organ transplantation.  Every year, countless lives are saved through this amazing medical technology.

Unfortunately, the number of patients on waiting lists far outnumber the donated organs available. This includes kidney transplant. In the United States alone, about 114,000 people are on the waiting list for a kidney.  In fact, more people, adults as well as children, are waiting for a new kidney (at least new to them) than for all other organs combined. Many, without it, will die.

And though kidney transplant surgery has been highly successful, like any surgery, it comes with risks and complications.  And among those risks are certain transplant-associated viruses.

One such foe is the BK virus.  This is a relatively common virus (up to 90% of the adult population in the world is seropositive) and one that most people get in childhood.  It feels pretty much like the common cold.  However, once you get over the symptoms, that doesn’t mean the virus is gone.  No, unfortunately—like lots of other malevolent viruses—it stays in your body.  However, in most cases, it lies latent; that is, it’s there but it leaves us alone and does not manifest as any sort of disease.

However, when your immune system is compromised the virus can come to life and cause symptoms that seem like an infection.  And here is where the issue with kidney transplant comes into play.  As many people know, our body’s immune system is made to fight off “foreign” objects and this would include someone else’s kidney. Thus, in order for a kidney transplant to work, patients are given “anti-rejection” medicines.  These medications suppress our own immune system’s attack on the new kidney.

And while that’s good news for the new kidney, it can be bad news for us in regard to the BK virus.  Our compromised immune system can open the way for the BK polyomavirus to “wake up” (for lack of a better term). The irony is that the BK virus itself can damage the kidney and even cause your body to reject it.  This doesn’t always happen, but doctors do keep an eye out for this virus, just in case it does.

Unfortunately, the BK virus isn’t the only viral threat. Another is the JC virus (a relative of BK) which exists in perhaps as much as 80 per cent of the adult population in the United States.  The JC virus, too, typically remains asymptomatic. However, it can, and often does, establish a lifelong latency in various parts of the body, including the kidneys.

However, just as with BK, the use of anti-rejection drugs following a kidney transplant opens the way for the JC virus to wreak havoc in patients, sometimes causing a dangerous condition called progressive multifocal leukoencephalophy (PML) which attacks the brain and often leads to severe disability or death.  Though once believed to be very rare in transplant patients, recent studies show that up to 5 percent of transplant organs (heart, liver, and kidney) show evidence of the virus.

As if BK and JC weren’t enough, there is also the more common Cytomegalovirus (CMV), which also can occur in kidney transplant patients.  CMV belongs to a different virus family than do the other two viruses. It is a member of the herpesvirus family, the same family of viruses that cause chicken pox, herpes simplex, and mononucleosis.  Billions are infected with CMV, and once they have it, it never goes away, even if it might not always manifest itself, much like the BK and JC viruses.

For transplant patients, including kidney transplant, it is estimated that up to 60 per cent of patients can get symptomatic infections from CMV. It’s a big problem with no easy answer, and researchers are still working hard to help patients who have it.

Indeed, we’re not talking Frankenstein silliness here. We are talking something much more serious: kidney transplants.   And, at Advanced Biotechnologies, we can help those who have been given the gift to continue enjoying it.

L’chaim. “To life!”