Cannabidiol, transplants and grafts
Every year worldwide, more than 150,000 organ transplants are performed (Global Observatory on Donation and Transplantation). For the patient receiving the transplant, these procedures often represent a last chance operation. Even after the operation, there are risks, particularly that of graft rejection. In France, more than 5,000 transplants are performed each year for more than 20,000 people waiting for an organ, on which their lives sometimes depend.
History
It is in Egyptian and Greco-Roman mythology that we find the first representations of grafts, but also in Christian literature. In ancient India, Sushruta, a surgeon credited with a founding surgical treatise of Ayurvedic medicine, described skin grafts to rebuild amputated noses. In the sixteenth century, the Italian surgeon Gaspare Tagliacozzi was one of the pioneers of facial reconstructive surgery. It was in the early 1900s that the first organ transplants on humans were attempted. Unfortunately, each time they resulted in the death of the patient. One of the main causes is the rejection of the graft by the immune system. Treatments were later developed to dampen the body's response. Some important dates:
- 1905: first corneal graft
- 1952: first kidney transplants
- 1963: first liver transplant
- 1967: first heart transplant
- 1968: first bone marrow transplant
- 2000: first double hand transplant
- 2010: first total face transplant
Of all organ transplants, kidney transplantation is the most common. When the "new" organ has been transplanted, the recipient's body will consider it as a foreign body and will want to destroy it by directing an immune response towards it: this is called transplant rejection.
Treatment
The main risk during a transplant is rejection. In order to promote the "taking" of the graft, an anti-rejection treatment and sustained monitoring are implemented. Immunosuppressive drugs will block the recipient's immune system and prevent the body from reacting. However, this treatment has an important side effect, since it will make the patient much more vulnerable to infections.
CBD and transplants
CBD is a cannabinoid from industrial hemp (Cannabis Sativa), it is not a psychotropic drug like its famous cousin THC (Cannabis Indica). Cannabidiol (CBD) is of growing interest to researchers who are launching numerous studies on its possible effects. A small study in 2015 (Yeshurun et al.), on 48 stem cell transplant patients, compared with 101 earlier patients rather than a randomised control group, reported a lower incidence of graft-versus-host disease when CBD was added to the usual treatment under medical supervision. This single study does not allow any conclusion. CBD is not a medicine and may interact with immunosuppressive drugs (via the CYP450 liver enzymes): a transplant patient must never take CBD without the advice of the transplant team.
