Drug tackles new challenges in kidney, liver transplants

MANILA, Philippines - A paradigm shift in kidney transplantation in the last decade has shifted the focus from preventing acute organ rejection to preventing chronic graft (transplanted kidney) dysfunction and mortality in transplant patients with functioning grafts.

“mTOR inhibitors, such as everolimus, have the potential to address the new challenges brought about by the paradigm shift in kidney transplantation,” said Dr. Hin Seng Wong, head of the Department of Nephrology of Hospital Selayang, Malaysia.

According to Hin, mTOR inhibitors improve long-term kidney transplant outcomes because they do not damage the kidneys; they prevent and improve chronic allograft nephropathy, the leading cause of kidney transplant failure; protect the heart; reduce incidence of cancer; and decrease the risk of opportunistic infections in post-kidney transplant patients.

Hin was one of the speakers in the 2013 Asia Cluster Transplantation Summit held last Oct. 18-19 at the Sofitel Philippine Plaza in Manila. Organized by the National Kidney and Transplant Institute (NKTI) and Novartis Healthcare Philippines with the theme, “Evolving Paradigms in Solid Organ Transplantation,” the summit was attended by more than 100 kidney and liver transplant specialists from Bangladesh, Indonesia, Malaysia, Maldives, Pakistan, Sri Lanka, Taiwan, Thailand, Vietnam and the Philippines. It is the first regional summit on transplantation held in the country.

“In July 3, 2012, in line with Kalusugan Pangkalahatan or our Universal Healthcare program, the Philippine Health Insurance Corp. launched the PhilHealth Z benefit package for catastrophic illnesses to ensure that qualified Filipino patients have access to kidney transplantation,” said Health Secretary Enrique Ona, who delivered the opening remarks during the summit.

Developed by PhilHealth and Novartis Healthcare Philippines with NKTI as the implementing reference hospital, the Z kidney transplant benefit package provides qualified PhilHealth members with access to research-based immunosuppressant treatment, including induction therapy.

The package provides the largest benefit of P600,000 that includes pre-transplant evaluation for the recipient and donor, hospitalization during the operation, and one-month post-transplant follow-up for the recipient and one-year post-transplant follow-up for the donor.

Ona revealed that the Z kidney transplant benefit package has been expanded to three more hospitals, one in the Visayas and two in Mindanao.

He also acknowledged the Transplant Society of the Philippines for providing kidney transplantation to patients through tertiary hospitals in Metro Manila and three other major cities in the country.

He also thanked Novartis Healthcare Philippines for significantly lowering the cost of anti-organ rejection medicine for kidney transplantation in the country.

“Everolimus provides a multi-faceted treatment approach to help improve long-term outcomes,” said Prof. Steve Chadban, director of kidney transplantation at the University of Sydney in Australia.

“Everolimus is backed up by a wealth of data that demonstrate its efficacy in providing protection from acute organ protection, malignancy and viral infection, as well as the benefit it provides to the kidneys, the heart and blood vessels,” said Prof. Julio Pascual, head of the Nephrology Department and Kidney Transplantation at Hospital del Mar in Barcelona, Spain.

“This summit aims to provide kidney and liver transplant specialists in the region with an opportunity to share experiences and insights in order to enhance transplant medicine and the quality of care of transplant patients,” said Dr. Angel Joaquin Amante, past president of the Transplant Society of the Philippines and overall chair of the Scientific Committee of the 2013 Asia Cluster Transplantation Summit.

“The number of Filipino patients on dialysis is increasing by about 10 percent every year. Many dialysis patients will eventually require a kidney transplant. Scientific events such as this transplant summit are crucial in furthering knowledge and expertise in transplant medicine in the country,” said Dr. Romina Danguilan, chair of the NKTI’s Department of Adult Nephrology and overall chair of the Scientific Committee of the 2013 Asia Cluster Transplantation Summit.

“We are privileged to work with the NKTI in organizing this important regional event. The NKTI and Novartis Healthcare Philippines implement various projects to support continuing education, training and research in order to achieve best standards of solid organ transplant service and care in the Philippines,” said Stephanie Franco, business franchise head for integrated hospital care, critical care, and bone of Novartis Healthcare Philippines.

Everolimus is one of the most-extensively studied immunosuppressants in solid organ transplantation with more than 10,000 transplant recipients enrolled in Novartis-sponsored clinical trials worldwide.

It is approved in more than 90 countries (including the Philippines) to prevent organ rejection for kidney and heart transplant patients.

In addition, everolimus is approved in the European Union and other countries worldwide (including the Philippines) to prevent organ rejection for liver transplant patients.

In the US, everolimus is approved for the prevention of organ rejection in adult patients at low-moderate immunologic risk receiving a kidney transplant, and is also approved in adult patients following a liver transplant.