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New results from the MELODY study highlight the variations in care experienced by transplant patients at different hospitals

06 March 2024

Preliminary findings on the approaches taken to long-term immunosuppression in kidney transplant patients enrolled in the MELODY study presented today at the British Transplant Society Congress showed a concerning level of variation between different hospitals.

Lady presenting on stage
Michelle presenting the MELODY study results

The MELODY study, co-funded by Kidney Research UK, involved more than 28,000 patients across the UK treated with medications that reduce how well their immune systems function (known as ‘immunosuppression’), including those with solid organ transplants, blood cancer and autoimmune diseases (including vasculitis and lupus).

New results, presented by Dr Michelle Willicombe from Imperial College Healthcare NHS Trust, showed that the proportion of kidney transplant patients receiving 3 combined immunosuppression medications after one-year post-transplant, ranged between 12-69% across UK centres.  Further investigation is needed to confirm this finding, but the research team could not explain the differences based on any clinical factors. 

Michelle added "We know that approaches to immunosuppression vary across UK kidney transplant centres, but this is the first time that data on long term treatments has been studied.  The differences between the centres are quite stark. I think the data shows the need for better information on long term use of immunosuppression and the corresponding outcomes within the UK.  We need to make a commitment to provide a more individualised approach to immunosuppression and step away from variation introduced by postcodes."  

About the MELODY study

MELODY researchers investigated whether patients developed antibodies (proteins that are produced by the body’s immune system to help fight infection) against the virus that causes Covid-19, following a minimum of three vaccinations.  

Study participants, who were recruited between December 2021 and June 2022, used a home-based, self-administered rapid Covid-19 test. Unlike the well-known lateral flow rapid antigen tests which show current infection with the Covid-19 virus, patients provided a droplet of blood from a self-administered thumb or finger prick in order to detect long-lasting antibody protection. Researchers also asked participants to complete a questionnaire online, covering demographic information, details of immunosuppressive treatments and behaviour.  

MELODY is the largest study ever to be performed in people with rare diseases and solid organ transplants. 

Results overview

Previous results from MELODY, published in The Lancet Rheumatology last year, showed that transplant recipients receiving 3 combined anti-rejection medications were least likely to have detectable antibodies following at least 3 Covid-19 vaccines, suggesting such recipients have the weakest immune systems.  Further results on the association between antibody responses, Covid-19 treatments and Covid-19 infection are due to be published later this year.

Dr Aisling McMahon, executive director of research and policy at Kidney Research UK noted “Ensuring that all kidney patients, from all backgrounds and areas of the UK, receive equal access to the best treatments is an important area of focus for Kidney Research UK. The MELODY study is a crucial source of information to inform and enable this and the results presented today provide valuable new evidence on the challenges that we face. I’d like to thank all the patients and researchers who have made this work possible and look forward to working on the next steps of this project”. 

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