Kidney

This study will use declined human kidneys to study the mechanisms of ischaemia reperfusion injury and how it can be ameliorated using novel therapeutic interventions. It is anticipated that this information will help develop evidence-based guidelines for the suitability of kidneys for transplantation and ultimately increase the number of kidneys transplanted and their outcomes.

The tissue from the same kidneys will also be used to study normal and pathological processes in the kidney, thus maximising the translational and clinically important data that is generated from the discarded tissue.

• Full title: Study of renal ischaemia-reperfusion injury and its amelioration
• Start date: 1st August 2012
• Sponsor organisation: University of Cambridge
• ODT study number: 2

This study aims to understand the contribution of the glomerular endothelial cells to the glomerular filtration barrier, and to examine how this normal function is disturbed in disease states. Then ways of therapeutically correcting these disturbances can be explored.

• Full title: Establishment of cultured human glomerular cells for study of glomerular function in vitro
• Start date: 21st November 2006
• Sponsor organisation: University of Bristol
• ODT study number: 19

Autoantibodies are associated with a number of kidney diseases, and antibody-mediated rejection has a negative impact on transplant outcomes. We are using human kidney tissue to profile resident immune cells using multiparameter flow cytometry, mass cytometry, and RNA sequencing, as well as complementary mouse models to understand function.

• Full title: Characterisation of ischaemia reperfusion injury in human kidneys
• Start date: 18th October 2012
• Sponsor organisation: University of Cambridge
• ODT study number: 23

New technology means that it is becoming easier and easier to identify the genes that cause certain diseases. Unfortunately, identifying a gene doesn't explain how it causes the disease. This requires a lot of laboratory work using cell and animal models.

However, animal models only tell us how things work in the animals that we use, and to see if a finding is true in humans, it is important to look in human tissue.

• Full Title: Identification of genes involved in renal, electrolyre and urinary tract disorders
• Start Date:1st April 2014
• Sponsor Organisation: University College London
• ODT Study Number: 40

This study is investigating candidate therapeutic agents during EVNP. This is in addition to investigating Antisense Oligonucleotide (ASO) therapeutics and cell therapy products during EVNP.

• Full title: Establishing ex vivo normothermic perfusion (EVNP) of kidneys for transplantation
• Start date: 1st April 2015
• Sponsor organisation: Newcastle University
• ODT study number: 48

Ex-vivo normothermic perfusion (EVNP) is a technique of preservation that involves warming the kidney to normal body temperature with an oxygenated red blood cell based solution. It has been shown to improve the outcome of kidneys from older and marginal donors.

It is also a valuable device on which to assess the quality of a kidney before transplantation. Adopting this system to assess the quality of a kidney could potentially allow more kidneys to be transplanted.

This study aims to assess the quality of kidneys that have been declined for transplantation by other transplant centres through the national allocation system and through the fast-tracking system. If they are deemed suitable they will transplanted into an appropriately matched recipient.

• Full title: Quality assessment of Human Kidneys by Ex-vivo Normothermic Perfusion prior to Transplantation
• Start date: 4th November 2015
• Sponsor organisation: University of Cambridge
• ODT study number: 53
• Study sites: Guy's, London; Newcastle; Cambridge 

The current paradigm in antibody incompatible transplantation (AIT) is to remove antibodies in the recipient prior to transplantation.

However, the process of removing antibodies may be impossible or very difficult in deceased donor transplantation.

This project offers a new paradigm by way of protecting the kidney graft endothelium using normothermic perfusion, which allows the organ to be maintained at body temperature outside either donor or recipient, and permits delivery of specific agents which can protect the kidney against antibodies.

• Full title: Transplanting the untransplantable - extending antibody incompatible transplantation using a normothermic perfusion model with cytoprotective agents
• Start date: 19th December 2016
• Sponsor organisation: Guy's and St Thomas's NHS Foundation Trust
• ODT study number: 63

At time of death, large numbers of white blood cells (passenger leukocytes) enter the kidneys and are then passed onto the recipient during transplantation. Removing these cells may improve transplant outcomes.

This study looks at PLs whilst the kidney is on Ex Vivo Normothermic Perfusion (EVNP).

• Full title: Mobilisation and depletion of passenger leukocytes during warm perfusion of discarded deceased donor kidneys 
• Start date: 31st August 2018
• Sponsor organisation: Guy's and St Thomas's NHS Foundation Trust
• ODT study number: 73

The QEUH transplant team have been trained by other units in EVNP, but require 5-10 kidneys to train local theatre staff in the technique before their first clinical case.

• Full title: Ex-vivo normothermic perfusion (EVNP) for the resuscitation and assessment of human kidneys prior to transplantation
• Start date: 17th September 2019
• Sponsor organisation: N/A - this is an educational project
• Study site: Queen Elizabeth University Hospital, Glasgow
• ODT study number: 93

This study is testing the use of a precision cut slice (PCS) system – 8mm by 0.25mm discs of living human tissue that contain all cell types found in the tissue in the correct orientation – as a model for investigating kidney fibrosis. 

• Full title: Development of a human precision cut slice (PCS) model to study renal inflammation and fibrosis
• Start date: 1st March 2020
• Sponsor organisation: Newcastle University
• ODT study number: 96