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Our Research - Liver & Gastrointestinal Transplantation

PROJECT 1: Immunotherapy with Natural Killer Cells for Patients that Receive a Liver Transplant Due to Liver Cancer

PROJECT SUMMARY:

Liver transplantation has emerged as one of the few curative treatment modalities for patients’ medications that decrease the immune defenses so that the body can accept the new liver. If patients do not receive these medications, their body will reject the new liver. Due to the fact that the body’s immune defenses are suppressed by the anti-rejection medications after the transplant, there is a risk that some cancer cells that still exist in the body may multiply and then liver cancer may recur.

During the transplant procedure the old liver that has cancer, is removed and is sent to pathology. According to the extent of the disease in the removed liver, an oncologist may prescribe prophylactic chemotherapy after the transplant to decrease the chances of disease recurrence.

GOAL:

The aim of this study is to try an additional form of treatment that might decrease the chances of disease recurrence. This form of treatment is the infusion of a particular type of cells, called Natural Killer (NK) cells extracted from the donor liver. Natural killer cells are a type of lymphocytes (white blood cells) that are present in the blood and play a role in the defense of the organism. In laboratory experiments it has been shown that when we place these cells together with cancer cells, the natural killer cells can attach to the cancer cells and kill them. Experimental evidence shows that Natural Killer cells can kill liver cancer cells they come in contact with.

Where to find Natural Killer Cells:

At the time that the transplant team is harvesting the new liver from the donor, they will also collect the donor’s Natural Killer cells.  During the procurement of the liver from the donor, the organ is flushed with a sterile solution to flush away all the blood cells and prepare the organ for the transplant.  This solution will be collected at the time of organ recovery.  The cells that are in this solution will be purified, and Natural Killer cells will be extracted from the solution, cultured and activated.

Soon after the transplant, (3 days after the transplant), the Natural Killer cells will be collected from the culture and will be infused in the patient through a peripheral vein.

We will study liver cancer patients that have received a liver transplant.  They will be also be followed by an oncologist and will receive the standard prophylactic treatment (chemotherapy) for cancer, as indicated by their oncologist.  Half of them, the study group, will also receive this Natural Killer cell infusion. After the transplant, all patients will undergo frequent monitoring to detect the recurrence of liver cancer.  We will compare the outcome of the patients in the study group versus the patients that received only the standard of care treatment.

This form of therapy is called immunotherapy.  It is different from chemotherapy which is usually a synthetic compound toxic for all our organs.  In this treatment we use natural cells of the body that can increase the defenses of our immune system and attack only the cancer cells like a smart bomb, sparing the rest of the organism.

Significance:

This immunotherapy will improve the outcome of patients that receive a liver transplant as a treatment for liver cancer.