A Better Way To Deliver Drugs To Transplant Patients

Doctors say they may have the first advancement in nearly a decade to save the lives of lung transplant recipients

August 10, 2004

While an organ transplant can offer new hope for the lucky recipient, patients are still at risk. Rejection rates of donor organs are such a huge complication, only 50 percent of transplant patients survive more than four years. Dr. Dean Edell explains how doctors may now have found a way to improve survival.

This daunting row of pills is a necessary part of an organ recipient's life.

Bill Settino, lung transplant patient: "I take about 25 to 29 pills a day. Sometimes, I don't have to eat."

It's a lot, but when an autoimmune disease caused his lungs to start failing, Bill Settino was running out of options.

Bill: "I had 54 percent capacity in one, and 46 in the other."

A lung transplant was his last hope. But even with strong medications, the organ is often rejected.

Aldo Iacono, M.D., pulmonologist: "There have not been advances in therapeutics in lung transplantation over the last 10 years, so that the average survival is only about three to four years."

One problem seems to be the delivery system. when patients take anti-rejection drugs like cyclosporine pills, they can suffer major side-effects throughout the body. Sometimes the pill effects seem to stop working.

Dr. Aldo Iacono may have an advance that can extend Bill's life even more.

Three times a week for two years, transplant patients breathe in an aerosol form of the anti-rejection drug cyclosporine.

Dr. Iacono: "The concept is that if you inhale the drug, it'll go directly into the lung where rejection takes place."

Early studies are exciting. Patients function better and survive longer.

Dr. Iacono: "It's hard for me to believe it myself, but they are what they are."

Four years after his transplant, Bill has all the confirmation he needs.

Bill: "I've been off it about two and a half years, and I still have not had rejection, so maybe that's the reason that I didn't, because of the cyclosporine."

He's back to working full-time and looking forward to many years to come.

Doctors say because the drug goes directly where it is needed, there are fewer toxic side effects in other parts of the body. This drug is still in clinical trials and awaiting FDA approval.

Copyright © 2004 ABC Inc.

This article posted September 4, 2004.