Transplantation Clinical Study Group
Kidney transplantation is the treatment of choice for end-stage kidney disease. A successful kidney transplant improves both the quality of life and the length of life for most patients when compared with maintenance dialysis.
Around 3,300 people receive a kidney transplant in the UK every year from either a living or a deceased kidney donor. Patients must take drugs to suppress their immune system to reduce the chances that it will 'reject' the new kidney. Disabling the immune system can lead to an increased number of infections and cancer, so patients require life-long close follow-up after transplantation. A living donor kidney may function, on average, for over 20 years, and a deceased donor kidney for over 15 years.
Who we are
We are dedicated to initiating and supporting clinical research in renal transplantation and have a network of interested and enthusiastic researchers in every transplant unit. We merged with the UK Renal Registry Transplant group and work closely with the British Transplantation Society Clinical Trials Committee (chaired by Michelle Willicombe).
Our group is chaired by Caroline Wroe and Dr Ed Sharples.
Caroline is a Consultant Nephrologist at Newcastle Hospitals NHS Foundation Trust and Clinical Director of the NIHR Clinical Research Network for North East and North Cumbria. She has experience as a Principle and Chief Investigator and is passionate about the positive impact of research on clinical outcomes for patients and seeks to promote inclusion, opening up research opportunities for colleagues and patients.
Ed is a consultant in renal and transplant medicine in Oxford. He did his training in Oxford and London, completing a PhD at the William Harvey Research Institute. He has been training programme director, member of a Specialist Advisory Committee, and is a member of Kidney Research UK’s Research Grants Committee.
Our aims:
- Engaging renal units in a research network, recruiting patients to high-quality clinical research studies.
- Identifying evidence gaps where research is required.
- Providing a forum to discuss, develop and conduct clinical trials.
- Disseminating information about investigator-led and commercial studies.
- Increasing research awareness for patients and their relatives, doctors in training and colleagues in other professional groups.
- Making it routine for patients to ask ‘Which trial can I join?’
Our challenges:
- Improving long-term outcomes.
- Personalising immunosuppression, controlling rejection and avoiding infections and malignancies.
How we can overcome them:
Develop a national recipient biobank to transform patient management
- Prospectively collecting biological samples from a large cohort of well-characterised recipients.
- Identifying novel biomarkers, enabling risk prediction and stratification and early intervention.
- Finding potential therapeutic pathways to enable novel drug development
- Assessing the impact of donor interventions on a national basis.
This complements Kidney Research UK’s ambition of “one transplant to last a lifetime” with doubling of graft longevity by 2030. It is also a logical extension to the QUOD initiative (established donor biobank).
National outcome data collections
- Building on current patient data collections (NHSBT, the UK Renal Registry, local unit data), we need more robust analyses to enable the best management of post-transplant complications.
- Using RaDaR to collect information on specific post-transplant complications, beginning with BK Nephropathy.
- EpCOT - Epidemiology of Cancer after Solid Organ Transplantations study (Adnan Sharif, Birmingham) - record linkage between national registries (eg transplant, cancer, hospital administration and mortality) to provide a comprehensive analysis of cancer and mortality risk.
Re-purposing licensed drugs for use in transplantation (eg SGLT2 inhibitors, belimumab, Il-6 blockade, Syk blockade).
Ongoing studies:
ITOPS - Increasing transplant opportunities for sensitised patients. Led by Siân Griffin, Cardiff, Rommel Ravanan, Bristol and Sunil Daga, Leeds. Open to recruitment. Funded by Garfield Weston Foundation (£500K). @ITOPST.
TAR:GET 1 - Transplant Antibody Mediated Rejection: Guiding Effective Treatments - comparing standard of care (SOC – plasma exchange + IVIg) to SOC plus rituximab. Led by Michelle Willicombe, Imperial College, London. Trial in set up. Funded by Kidney Research UK/NIHR.
ASK - AccesS to living-donor Kidney transplantation - a feasibility trial of a complex intervention. Led by Pippa Bailey, Bristol. Trial in set up. Funded by Wellcome Trust.
Other studies we are supporting:
HOT2 - Heme oxygenase-1 in renal transplantation: a randomised, controlled trial of heme arginate (HA) in recipients of deceased donor kidneys. Chief Investigator: Lorna Marson, Edinburgh. Open to recruitment. Funded by Kidney Research UK (£739K). @Hot2Trial.
PITHIA – Pre-Implantation Trial of Histopathology of Renal Transplant Allografts. Chief Investigator - Gavin Pettigrew, Cambridge. Funded by NIHR RfPB (£350K). www.pithia.org. @pithia_trial.
OuTSMART – Optimised Tacrolimus and MMF for HLA Antibodies after Renal Transplantation. A randomised controlled clinical trial to determine if a combined screening/treatment programme can prevent premature failure of renal transplants due to chronic rejection in patients with HLA antibodies. Chief Investigator - Anthony Dorling, King’s College, London. Funded by NIHR EME (£2.6 million).
From potential donor to actual donation - how does socioeconomic deprivation affect the recruitment and progression of living kidney donors? A quantitative mixed methods observational study. Chief Investigator - Pippa Bailey, Bristol.
BioPASsPoRT - Biomarkers for Patients Assessment and Stratification post Renal Transplantation. Led by Matt Wellberry-Smith, Leeds. Funded by Innovate UK, Randox Health.
Got a question? Get in touch.
For more information and to find out about getting involved as a patient or researcher, contact: