Why we fund transplant research
There are thousands of Canadians living with transplanted organs. In 2014, 2433 solid organ transplants were performed in Canada, with almost 5000 people on wait lists. Transplantation is now considered a very effective therapy for organ failure, thanks to advances in surgical and medical techniques. But all of these patients are still living on borrowed time because transplant is not a cure.
Outcomes have improved dramatically, at least in the short term. At one year, heart transplant patients have a survival rate of 88% and at 5 years that survival rate drops to 75%. But we have not seen a similar jump in long-term (10+ years) graft survival. For example, at 15 years post-transplant for adult heart patients, the survival rate is less than 40%. For pediatric heart transplant patients, 5 year survival is 83%. Adult and pediatric lung recipients have an even tougher road – just over half live longer than five years. For patients under 18, the 10-year survival rate for heart transplant is less than 60%, for lung it is 44% and liver is 77%.
One of the biggest barriers to long-term quality of life for transplant recipients is the body’s immune system. There is still much to learn about how our immunological responses can lead to life-threatening acute or chronic rejection. A complex cocktail of immunosuppressant drugs keeps rejection in check, but it is a delicate balancing act between the benefits of the toxic medication and the negatives of wide-ranging side effects – a twofold increase in the risk of certain cancers, infections, high blood pressure, diabetes and kidney damage. When the immune system is knocked down with drugs, the body no longer naturally fights off bacteria, viruses or cancer cells.
Each patient also needs extensive monitoring to ensure any complications are managed as quickly as possible. For most organs, the only way to check for rejection is through a biopsy – a time-consuming, costly and invasive procedure. But often, signs of rejection or organ failure are not evident until the damage is irreversible.
For researchers, the ultimate goal is a long and healthy life for patients and their donated organs, without the need for aggressive immunosuppressive drugs or invasive testing. We may be close. There is exciting work underway at hospitals and universities across Canada and around the world.
This is why ongoing, innovative transplantation research is critical. In order to better care for transplant patients, research must continue to address the health challenges associated with transplantation so one day it is a cure.