Transplant Research at Penn Medicine
Among Penn Transplant Institute's broad-based initiatives, the following ground-breaking areas of investigation are noteworthy for their recent contribution to transplant research:
Preventing Organ Rejection
Penn Transplant Institute Director Abraham Shaked, MD, PhD, is leading a National Institutes of Health (NIH)-funded study of kidney donors to determine whether acute rejection can be predicted by sequential mRNA profiling of urinary cells. Secondary goals of this study include determining whether pre-emptive treatment based upon mRNA profiles can be used to prevent acute rejection and preserve glomerular filtration rate and whether these mRNA profiles can be used to guide the withdrawal of calcineurin inhibitors in stable recipients and other aspects of immunosuppression management.
Exploring pathways of injury can identify an organ at risk of failure and lead to improved treatment strategies. Currently, 10 to 25 percent (depending on the organ) of all transplant recipients experience abnormal function of the organ that can have an impact on long-term organ rejection.
Artificial Organs and Mechanical Organs
In 1975, Penn participated in the groundbreaking NIH-funded multicenter study that first explored sustained heart bypass for patients with devastating heart injuries. Since this time, Penn has been at the vanguard of mechanical-assist device technology research to support patients awaiting transplant. Each year, these devices help up to 30 percent of waiting individuals survive long enough to receive a new heart.
The Penn Transplant Institute was the first in the region to send a patient home with a left ventricular-assist device (LVAD) system and the first hospital in the northeastern United States to implant the temporary Total Artificial Heart (TAH-t). Research has shown that patients receiving the TAH-t have almost twice the survival rate as patients who received standard ventricular-assist devices. Penn researchers are now studying a new portable device driver that would allow TAH-t recipients to return home while they wait for transplant.
Living Donor Liver Transplantation
The Penn Transplant Institute is one of nine centers participating in a NIH-funded multicenter study of adult-to-adult living donor liver transplantation. The Adult-to-Adult Living Donor Liver Transplant Cohort Study (A2ALL) investigates the experience of a group of patients eligible for living donor liver transplantation, focusing on the factors influencing outcomes of living donor liver transplants for both donors and recipients. Researchers compare outcomes of this new procedure with the outcomes for patients who receive livers from deceased donors.
The Penn Transplant Institute performed its first adult-to-adult living donor liver transplant in 1999. The liver transplant team, led by Kim Olthoff, MD, is currently studying liver function and liver regeneration in transplant recipients and donors following surgery, specifically the effects of antirejection therapy and gene therapy. The results of this extended study will give liver transplant patients and potential donors solid information about the risks and benefits of this innovative and sometimes controversial procedure.