Transplantation advances outlined during fifth annual Shumway Lecture
Sir Roy Calne delivered this year's Shumway Lecture. (Photo by Donna Jones Bailey).
More than three decades into the era of transplantation, rejection remains the No. 1 enemy, Sir Roy Calne said during the fifth annual Shumway Lecture at Vanderbilt University Medical Center.
Calne, whose research of the powerful immunosuppressant drug cyclosporin in the 1970s helped revolutionize the field, discussed his pioneering work to fight the enemy of organ rejection without the high cost of side effects from medications to suppress the immune system.
The next big advance in transplantation, Calne predicted, will be achieving a condition he calls "almost tolerance," where the transplanted organ is accepted without the need for the high doses of immunosuppressive drugs that are now required.
"Our goal would be complete acceptance of the graft without paying a price," Calne told an audience of physicians, nurses and medical students gathered in 208 Light Hall.
"Well, there is no such thing as a free lunch. It's not likely we'll be able to reach total tolerance, but there's no harm in having a goal to be aiming at."
During the lecture, Calne outlined his work in the laboratory and in early clinical trials to achieve "almost tolerance" by manipulating the immune system with innovative drug regimens. So far, he said, preliminary results have been encouraging.
"It may be possible to render the immune system temporarily in a paralytic state so that as it recovers, it absorbs the new graft in a friendly way instead of in an aggressive way," said Calne, professor of Surgery at Cambridge University.
The Shumway Lecture is sponsored by the Vanderbilt Transplant Center in honor of Norman E. Shumway, M.D., Ph.D., for his contributions to heart transplantation research and surgery.
Shumway, a 1949 graduate of Vanderbilt University School of Medicine, is Frances and Charles D. Field Professor in Cardiothoracic Surgery at Stanford University, where he began studies on cardiac transplantation in 1958. Shumway and his colleagues also introduced the first clinical application of combined heart-lung transplantation in 1981, and he has consistently contributed to other aspects of cardiac surgery, with more than 450 publications in the field.
Calne began his research in organ transplantation in 1959 at the Royal College of Surgeons of England. During this period, he described the first effective immunosuppression for kidney transplantation, which he developed further as a Harkness Fellow at Harvard Medical School in 1960-61. The approach was applied to patients in 1962.
Calne established the Cambridge kidney transplantation program in 1965 and the first European liver transplantation program in 1968. In 1978, Calne conducted the first use of the then new, potent immunosuppressant medication, cyclosporin. The drug is now a cornerstone of the immunosuppression that makes the success of organ transplantation possible.
The following year, Calne performed the first pancreas transplant in the United Kingdom. In 1992, he performed the country's first intestinal transplant.