BACKGROUND: A widely used pill that keeps the body from rejecting an organ transplant has been converted into an aerosol solution that can be inhaled. A recent study indicates that over four and a half years, 84 percent of patients on the inhaled medicine survived, compared to only 56 percent of those on a placebo.
THE PROBLEM: Compared to other organ transplants, long-term survival rates following a lung transplant have not increased much over the last decade or so. Seventy-five percent of people with a lung transplant survived for the first year, but only 45 percent lived for five years after the transplant. In comparison, more than 70 percent of heart, liver and kidney transplant patients now survive more than five years. Scientists believe this is because a transplanted lung must breathe in everyday impurities in the air, triggering a rejection response in the lung.
BENEFITS: The aerosol form of cyclosporine delivers the drug more effectively to the tiny sensitive airways of the lung, where the threat of rejection is most serious. It also solves a toxicity problem: patients are unable to take larger doses of the pill format because it can lead to kidney damage. But the inhaled version can be taken in much higher dosages without increasing the level of toxicity.
WHERE TO GET IT: Chiron Corporation has licensed the inhaled version of cyclosporine, which came on the market in July.
ABOUT LUNG TRANSPLANT REJECTION: Any organ transplant carries with it the risk that the recipient's immune system would reject the organ. The body identifies the donated lungs as a foreign invader and attacks the transplanted organ. There are different kinds of organ rejection. Acute rejection involves blood vessels in the lungs; it usually occurs in the first three months after a transplant, and can be treated with anti-rejection drugs like cyclosporine. Chronic rejection occurs in the airways and becomes more resistant to treatment over time.