Can we remove white blood cells from donor kidneys to protect them from early transplant rejection?
Dr Maithili Mehta from the University of Cambridge has received a Michael Nicholson surgical trainee doctoral fellowship grant of £300,000 to look at methods of reducing inflammation and rejection in donor kidneys.
The problem
Around 10-30% of kidney transplant recipients experience acute rejection - this is when the recipient’s immune system recognises the new kidney as ‘foreign’ and damages it as part of a protective response. Transplant patients must take immunosuppressive drugs to protect their new kidney from this process by reducing the response of the immune system, but these medications also reduce protection against infections.
The solution
Maithili and the team will look at alternative methods to increase the life-expectancy of a donor kidney and to reduce the need for immunosuppressant medication.
They will do this by delivering treatments that may reduce inflammation to donor kidneys before they are transplanted, to investigate whether this will make them more likely to work better and less likely to trigger an immune response after being transplanted.
The team will use a technology called normothermic machine perfusion (NMP) which keeps the kidney alive outside the body and allows delivery of treatments.
First, Maithili will remove white blood cells from the donor kidney (the main cells responsible for stimulating the immune system) by adding filters to the NMP machine. They will then test drugs that block a molecule that causes inflammation.
What could this mean for kidney patients
“These interventions, if successful, will reduce the time lag between the kidney being transplanted and it starting to work, reduce the rate of transplant rejection, and potentially improve long-term kidney transplant function. This may also mean that in the future, patients can take lower levels of immunosuppressive drugs.” Dr Maithili Mehta
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