A transplant patient’s immune system attacks a donated kidney, liver, or heart as a foreign invader, forcing doctors to prescribe toxic drugs that can themselves cause lethal side effects. The MRC Centre for Transplantation has spent years developing ways to make transplanted organs last longer without relying on these harsh drugs. The team has created engineered proteins that, when placed directly into donor kidneys, reduce inflammation and dangerous blood clots after surgery. They have also pioneered a gentler approach: taking cells from the patient’s own body to coax the immune system into accepting the transplant naturally. Remarkably, by monitoring immune responses, researchers are now close to identifying which patients can safely stop taking conventional anti-rejection drugs without losing the graft. Advanced scanning techniques are also being developed to let physicians diagnose inflammation in a transplant and treat it early. Over the next five years, the Centre will run clinical trials to test whether these innovations actually extend transplant survival and allow more people to receive organs. Health economists are embedded in the team to forecast the real costs and benefits of bringing these methods into routine care.
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Organ transplantation has saved the lives of many thousands of people, but transplants still don't last as long as they should. In addition, to prevent rejection, high doses of toxic drugs are used to dampen the immune response. These can not only harm the transplant, but can have lethal side effects on the recipient. Since it started in October 2007, the Centre has made significant progress towards improving the health of people who need transplants. We have devised ways to make their transplanted organ survive longer. This includes the development of engineered proteins which, when planted in donor kidneys, reduce inflammation and blood clot formation after transplantation. In addition, we have pioneered less harmful, more natural methods to coax the immune system into accepting the transplant, using cells taken from the patient. Remarkably, as a result of monitoring the immune system, we are close to being able to judge which patients can stop taking conventional therapy without rejecting the graft. At the same time, we are developing advanced scanning techniques that will enable physicians to diagnose whether a transplant is inflamed and to offer appropriate treatment. As we approach the next five years of development, we shall conduct clinical trials to establish whether these innovations can benefit healthcare as the basic research has promised. Potential benefits include extending the life of the transplant and offering transplantation to more of those in need. We are also supporting new branches of science that make success more likely. Advances of this complexity are made possible by bringing together a large workforce of scientists, clinicians and technologists under the same roof. The MRC Centre for Transplantation has created this capability within the UK. It collaborates with the Centre for Medical Law and Ethics at King's College to ensure a high standard of communication and public engagement regarding the regulation and ethics of transplant research. A programme of special events and media coverage will help keep the public and patients informed during innovation. Health economists are also to be part of the Centre to provide the opportunity to make more accurate forecasts about the costs and potential benefits of our research. Future success will depend on recruiting and training the brightest minds to deliver this work through the next 5-10 years of development and ensure the research is translated into social and economic benefit.
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