A young woman gets a medication-free kidney transplant after MGH doctors transplanted bone marrow to make her immune system think the new organ was her own.

Jennifer Searl’s story starts in 1993 when she was 12 during a routine camp physical. Her mother, a nurse, asked the doctor to check for anemia as Jennifer always looked pale. The results confirmed that she was indeed anemic. Even worse, Jennifer suffered from kidney disease and her kidneys only functioned at 15 percent of normal.

“We sort of fooled the immune system into considering the donor organ as part of its own body,” says David Sachs, MD.

Things moved quickly after the diagnosis. By the time Jennifer was 13, she had her first transplant, receiving a kidney from her father. To prevent rejection, she took more than 30 pills a day. The side effects were almost too much to bear. Jen developed osteopenia, a weakening of the bones. The steroids caused her to gain weight and grow facial hair – devastating for a teenage girl. Even worse, viral warts covered Jennifer’s feet. She could barely walk and used a handicapped permit all through college.

At the same time Jennifer struggled with the side effects from her transplant, her kidney was failing. She needed a new one. “My mom learned about a research study at Mass General that was going to give patients who needed a kidney transplant a bone marrow transplant as well, allowing them to stop all medications,” Jennifer says. “It was more exciting than anything. I never thought it would happen in my lifetime. I always thought I would have to take immunosuppressants forever.”

David Sachs, MD, researcher into transplants and the immune system
David Sachs, MD, whose team’s research into the immune system proved pivotal to Jennifer Searl’s kidney transplant.

Tricking the Immune System

In September 2002, Jennifer, 22, was the first to test the procedure developed by an MGH team led by David Sachs, MD, former director of the Mass General Transplantation Biology Research Center. This time around, Jennifer’s kidney came from her mother. The team transplanted her mother’s bone marrow along with the kidney.

The idea was to trick the immune system into accepting the new part as its own. One way to do this is by transplanting the donor’s immune system. Immune cells reside in the bone marrow, so when the donor’s bone marrow is transplanted, those immune cells can protect the new organ from rejection. The hope is that the recipient will no longer need to take anti-rejection medicine. “We sort of fooled the immune system into considering the donor organ as part of its own body,” Dr. Sachs says.

For the Mass General researchers involved, that success was both a milestone and an inspiration. Research efforts continue as the procedure is still considered experimental.

“This kind of work could only be done in a place that has the research capacity and the clinical capacity to carry it out,” Dr. Sachs says. “We know we can achieve tolerance. The next step is to make it more widely available.”

A Transplant Without Medication

“It’s like a dream come true—a transplant without medication,” Jennifer says.

Jennifer has already experienced what the procedure could mean for patients. After the kidney and bone marrow transplant, she was slowly weaned off medication. Although some side effects remained, the warts disappeared. The girl who hobbled around for years and was always sick, became an athlete. She competed in marathons and triathalons and served as captain of U.S. swim team at the 2009 World Transplant Games.

In 2013, Jennifer has been living drug free with her second kidney for 11 years. She is a health education project specialist at Mass General, a place she considers her second home. “It’s like a dream come true—a transplant without medication,” Jennifer says.

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