Announcements

QUOD & Live Life Give Life

Jenny Collins News 0 Comment

Dr Luke Yates, trustee of the organ donation charity Live Life Give Life, introduces the work of the charity and the exciting new partnership with QUOD

Live Life Give Life is a small UK charity that raises awareness of organ donation and the transformative power of transplantation. We are run by volunteers, who are all affected personally by organ donation and from all perspectives of the transplant journey – as recipients, donors, and survivors of those lost waiting. One of our prime objectives is to encourage people to talk about organ donation with their families. Our work is carried out via awareness campaigns, events and activities, and initiatives such as The Orgamites characters, which have been created to help young children understand organ donation. We also fund small research projects that aim to improve the welfare of (and outcome for) patients who need transplants, and travel fellowships to foster collaborative research for early career researchers.

Live Life Give Life was founded in 2006 by Emily Thackray and Emma Harris both afflicted by cystic fibrosis (CF). The two young women had lost many friends to CF and, at the time, Emily was on the waiting list for a life-saving lung transplant. The shortage of organs and donors inspired Emily and Emma to create a T-shirt campaign to raise awareness and encourage people to sign the organ donor register. Live Life then Give Life was their slogan and their fledgling charity; and went on to attain charity status in 2008. Emily received a transplant is 2007, and a further transplant in 2014, but tragically passed soon after. Emma also received a transplant and continued to fundraise and raise awareness for the cause but very sadly passed away early this year.

In a new project, Live Life Give Life is partnering with QUOD to develop a unique pump-prime funding opportunity to aid transplant researchers utilise this fantastic biobank resource. Watch this space – further details of the grant and how to apply coming soon!

Website: livelifegivelife.org.uk  X: twitter.com/lltgl
Facebook: facebook.com/LLTGL  Instagram: instagram.com/livelifegivelifeuk/

Spotlight on a QUOD Colleague – Prof Colin Wilson

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For this issue of the QUOD newsletter, we caught up with Colin Wilson, Professor of Transplantation and Hepato–Pancreato–Biliary (HPB) Surgery at Newcastle University, NHS-employed Consultant Surgeon, and QUOD Principal Investigator for Newcastle. We spoke to Colin about his academic and clinical roles in transplantation as well as his role within the QUOD programme, including how QUOD is supporting the development of a novel artificial intelligence (AI)-informed assessment of organ quality.

In his role as QUOD Principal Investigator for Newcastle, Colin coordinates specimen collection and onward transport to Oxford. He works with various teams within the Newcastle-upon-Tyne Hospitals Trust; the HPB team delivers the QUOD boxes to Oxford and the organ retrieval team underpins this. Colin actively supports the professional development of his team members and encourages their involvement with QUOD.

Colin leads a team at the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation, which is a collaboration between Newcastle and Cambridge Universities. The programme involves clinical work and registry analyses to look at ways to improve organ utilisation and provide a scientific basis to develop policies in clinical practice around organ utilisation. The programme delivers work packages, protocols, projects, and trials. One such trial is OrQA (Organ Quality Assessment), which, in collaboration with QUOD, is developing a tool that uses AI-driven analysis of photographic images of organs (taken using devices such as smartphones) to predict their suitability for transplantation by assessing factors such as perfusion quality or percentage steatosis (in liver). Colin recalled his experiences as a child using his first camera, the rigmarole of taking the film to be developed, and the wait to receive the prints, whereas nowadays we all have very high-resolution cameras on our phones that could be applied to transform our approach to medicine. His enthusiasm for the use of technology to advance transplantation outcomes is clear and is just one of his visions for the future of transplantation.

Looking ahead, Colin is keen to support medical students aspiring to become transplant surgeons and is actively involved with the North East Surgical Training Academy (NESTAC) training and mentorship programme, which connects students and trainees with mentors. He considers himself to be extremely lucky to be able to support some of the very talented medical students who are interested in careers in transplant surgery. The pathway to becoming a consultant transplant surgeon begins with a one-year laboratory-based MRes project that is written up in a thesis and presented as oral and poster presentations, which may go on to be presented at conferences and meetings, followed by progression to academic foundation doctor (core training level), academic clinical fellow, and finally clinical lecturer. The programme takes around 10 years from start to finish and Colin is very much looking forward to seeing the first person “come off the conveyor belt”, who he first met as a medical student keen to become a consultant transplant surgeon. He has mentored and supported him throughout his career development and says “it is going to be a really big moment that I’m looking forward to”.

Colin’s own journey to become a transplant surgeon began in 1999, when he was working as a Senior House Officer on a gastroenterology ward with Oliver James, Professor of Hepatology, at the Freeman Hospital, Newcastle. It was here that he realised that liver transplantation was key to the successful treatment of many patients with liver ailments. In 2001, he began his PhD, supervised by Prof. David Talbot, on non-heart-beating kidney transplantation, which was novel and challenging work at the time. He then went on to complete his training as a Surgical Registrar from 2006–2012.

While transplant surgery can present challenges, Colin describes his job as rewarding and he is very much future-focused. He is driven by research, developing technology, and building strong teams, and most enjoys creating and delivering novel solutions to overcome (or work around) the hurdles and obstacles facing transplantation. His research aims to identify how to make the best use of the resources available, such as finding ways to overcome non-use of organs from deceased donors and achieve good long-term outcomes for patients, while prioritising safety. He is passionate about supporting the next generation of UK transplant surgeons, who will also face issues for patients with organ failure but may consider newer approaches such as the use of stem cells, AI, or xenotransplantation, which has been approved in the USA but is not currently implemented in the UK.

Colin is unquestionably proud of his hugely dedicated and committed team, comprising particularly talented members, all with broad-ranging areas of expertise and who have won numerous esteemed prizes for their work in transplantation, published cutting-edge research, and are developing “staggering” novel AI work. He mentors his team academically and it is hugely important to him to provide them with an environment in which they can flourish.

Colin describes the QUOD programme as “engaging and outward-looking”, and really values the focus it brings to transplant research. Of particular importance to him are the governance structures in place, in addition to the core biorepository work, as well as the fellowship among like-minded individuals who can build projects on top of the infrastructure that QUOD brings. “It’s not just what QUOD is, but what QUOD has allowed to build around it and the connections that has made it such a valuable resource for UK transplantation.” He believes that the UK is world-leading in many areas of transplantation and QUOD is at the core of that.

In addition to his work in Newcastle, Colin’s job sees him travelling to and presenting at national and international meetings. He will be co-chairing the ESOT Congress 2025 in London, which will focus on sustainability, not just in terms of climate emergency but also workforce and the issues and challenges facing the NHS and European healthcare systems that are struggling to deliver doctors, nurses, and specialists in transplantation.

While his work has taken him to various countries over the years, outside of his busy full-time clinical and academic roles, Colin cherishes time with his family, enjoying activities such as table tennis and travelling together, and is looking forward to a family holiday in the next few weeks.

Interviewed by Jenny Collins.

New QUOD Colleague Questionnaire – Dr Jenny Collins

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Dr Jenny Collins – Tissue Handling Technician & Communications Officer

What were you doing most recently before joining QUOD? 

I had two part-time jobs before I started with the QUOD team. I worked in publishing, as a Managing Editor of an endocrinology journal and as a copy editor, and I also worked in a secondary school as a Science Technician.  
 

What interested you about working with QUOD? 
As well as my background in publishing, I previously worked at the University of Oxford in research. This role appealed as it gives me the opportunity to bring together my lab skills and publishing experience in an organ transplantation setting, which is hugely interesting and will have an enormous positive impact on people’s lives.  

What does your role involve? 

I receive biopsy samples from various tissues (heart, kidney, liver, and ureter) and process them for histology. The formalin-fixed paraffin-embedded samples are then stored in the QUOD Biobank until they are requested for research. When the samples are required for research, I then cut sections and prepare slides for histological analysis.
I will also be involved in public engagement and communications to help to increase awareness and visibility of QUOD and the incredible impact the biobank can have on transplant research.

Lightning round time: 

If you were stuck on an island what three things would you bring? 

 A radio, a knife, and a great book.

Where’s your favourite place? 
It has to be the Hermitage of Braid and Blackford Hill in Edinburgh. I grew up in Edinburgh and have a lot of great memories of family walks here, including rolling eggs down Blackford Hill at Easter, which has also become a family tradition with my own children.

Finally, what kinds of enquiries should people bring to you, and how best can they reach you? 

Any questions about tissue processing or communications can be sent to me via email: jenny.collins@nds.ox.ac.uk.

Mr Mohamed Elzawahry, Clinical Research Fellow from the Oxford Transplant Centre at the University of Oxford, attended the BTS congress to present his work

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The British Transplantation Society (BTS) annual congress was held in Harrogate, UK from 6th to 8th March 2024. Additionally, on Tuesday 5th March, before the official start of the congress, there was a post-graduate masterclass that featured a set of very interesting talks around sustainability and organ offering for transplantation. The congress was focused on sustainability and resource management in transplantation, this was emphasized by the choice of plenary discussions and talks showcased throughout the 3 days.

Our group submitted a number of abstracts on our work using QUOD samples, which investigate multiple transplant related questions, and we were delighted to be invited to present in multiple oral sessions. Dr Sarah Cross presented an update on QUOD and highlighted some of the research studies that the biobank has supported in the Basic Science session ‘Combatting Ageing’ which was co-moderated by Dr Maria Kaisar. Later in the congress, Dr Ioannis Michelakis presented “Donor Cystatin-C association with posttransplant graft function” in the main auditorium in the ‘Clinical Oral Presentations’ session. Dr Sarah Fawaz presented “Circulating TNFα, TNFR1 and TNFR2 Levels in deceased donors negatively associate with posttransplant kidney function” in the ‘Basic & Translational Science Oral Presentations’ session. All of which stimulated very engaging and interesting discussions.

I was honoured to have my abstract, “Oxygenated hypothermic machine perfusion (HMPO2) of the pancreas; comparing a ‘continuous’ and an ‘end-ischaemic’ approach in a porcine circulatory death model,” invited to be presented at the prestigious ‘7 of the best’ session. This was the result of a challenging set of experiments which have now paved the way to ongoing work supported by the QUOD whole organ research initiative.

The congress hosted a delightful drinks reception at the end of the first day and later on a vibrant themed gala dinner celebrating World Book Day. Throughout the event, networking was easy and engaging around the many industry and partner booths, including the QUOD booth staffed by Dr Sarah Cross and Philippa Wren. Overall, the congress was a great success, with excellent talks covering a wide range of multi-disciplinary interesting topics under the guise of transplantation.

QUOD’s British Transplantation Society (BTS) 2024 Overview

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QUOD attended the BTS Congress in Harrogate from 6-8 March. The annual congress brought together over 500 attendees and from our exhibition stand we were able to meet and connect with researchers, nurses, surgeons and clinicians, as well as charity and industry representatives and NHSBT staff in a wide variety of roles. Having the opportunity to talk to so many people involved in the QUOD programme from across the UK, as well as researchers who have previously or are currently using QUOD samples was so valuable. We were also able to raise awareness of the bioresource and highlight its value to potential future users.

QUOD had a large presence throughout the congress. In the ‘Diversity in Transplantation’ session, QUOD Steering Committee members Colin Wilson and Isabel Quiroga debated for and against ‘Women in Transplant: There are barriers to progressing in transplant surgery’. In the same session Menna Clatworthy, whose group at the University of Cambridge have received QUOD samples for a few research projects, participated in the panel discussion on ‘Socioeconomic, gender and ethnic diversity’. In the Basic Science session on ‘Combating aging’, QUOD National Operational Coordinator Sarah Cross presented an update on QUOD activity and highlighted some exciting work from several QUOD supported research projects in the area of organ aging.

Research using QUOD samples was presented in a number of presentations during the congress. In the prestigious Medawar Medal session, Stephanie Chong from UCL presented her work ‘Composition of the neutralising antibody response predicts risk of BK virus viraemia in renal transplant recipients’. QUOD has supplied Stephanie with donor serum and spleen samples to help facilitate this project and it was terrific to see the results being showcased in this notable session. Two biomarker studies in kidney transplantation which used QUOD donor plasma samples were presented by researchers from the University of Oxford. In the ‘Clinical Oral presentations’ session Ioannis Michelakis talked about his study ‘Donor Cystatin-C association with post-transplant graft function’. In the ‘Basic and Translational Science Oral presentations’ session Sarah Fawaz presented her work ‘Circulating TNFα, TNFR1 and TNFR2 Levels in deceased donors negatively associate with posttransplant kidney function’. In the ‘Calne Williams Medal presentations’ session, the latest developments from the OrQA project, of which QUOD is a collaborative partner, were presented by Georgious Kourounis from Newcastle University ‘Organ Quality Assessment for Livers (OrQA-L): Real-time visual assessment of steatosis during retrieval using machine learning models’.

As is BTS tradition, the gala dinner for this year’s congress had a theme, and due to it falling on World Book Day, delegates arrived dressed up as fictional characters ranging from Moby Dick, Gandalf and the Hobbit and Red Riding Hood, to a swarm of Where’s Wallys! It was a hugely enjoyable evening that ended with us dancing the night away on a packed dance floor to a particularly good live band.

We would like to thank BTS for its continued support and look forward to the 2025 congress where we can showcase more of our scientific collaborations and impact.

QUOD Whole Organ Expansion

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In 2018, a multi-disciplinary team of researchers from Oxford and Newcastle, led by Professor Rutger Ploeg and Professor James Shaw, was awarded a grant of £1.7 million from the Medical Research Council (MRC) to enable the expansion of QUOD to establish a whole organ tissue bank.

This funding enabled the central QUOD clinical data, blood / urine sample and tissue biopsy Bioresource in Oxford to be augmented by systematic processing of whole organ pancreas, heart and lungs from deceased organ donors to collect anatomically-driven mutimodal biopsies. This grant allowed QUOD to establish cross-cutting scientific platforms including state-of-the-art pathology, transcriptomics, proteomics and light / multiplex fluorescence / EM imaging. The QUOD-PANC tissue bank at Newcastle University has archived samples from 120 donors within a searchable online Atlas comprising from normal, ischaemic and chronically diseased pancreata. Underlying pathologies include type 1, type 2 and type 3c diabetes in addition to chronic pancreatitis and pancreatic intraepithelial neoplasia (PanIN).

About QUOD Whole Organ Resource

The QUOD whole organ expansion programme at Newcastle University is coordinated by scientists and clinicians including Professors James Shaw, Andrew Fisher, John Dark, Dina Tiniakos and Dr Bill Scott. Quality-assured tissue processing is undertaken by dedicated biomedical scientists led by Minna Honkanen-Scott within the Transplant Regenerative Medicine Laboratories at the International Centre for Life. Professor Paul Johnson leads a parallel research pancreatic islet isolation programme at the University of Oxford.

QUOD Expand facilitates integration of high-quality clinical data, circulating biomarkers and deep molecular phenotyping towards deeper understanding of the stresses associated with organ donation and transplantation together with the mechanisms underlying tissue pathologies. The overall goal is development of novel therapeutic strategies to optimise organ transplantation, tissue replacement therapy and in situ endogenous tissue repair.

(H&E stained image of an islet. 40x magnification)

Following dissection from surrounding tissue, the whole organ is assessed and photographed macroscopically before collection of multimodal biopsies from anatomically defined regions. Light microscopy images are obtained following a standard suite of dye and immunohistochemical stains for clinical pathologist assessment and Artificial Intelligence-driven image analysis (led by Professor Sarah Richardson, Exeter University). Standardised ultrastructural assessment by transmission electron microscopy has been validated.

The whole organ expansion programme has benefitted significantly from an NHSBT initiative Increasing the Number of Organs Available for Research (INOAR) which has included pancreata from donors with diabetes.

The QUOD expansion programme is aligned to the overall QUOD mission: ‘Saving lives and cutting health care costs by increasing the pool of transplantable organs, thereby addressing the growing gap between supply and demand in organ transplantation’ and provides a powerful new resource for disease-specific research.

QUOD Panc Atlas

An online Portal is in development providing access to a library comprising donor data; organ / tissue images; AI analysis; and a catalogue of samples available for research within the Quality in Organ Donation whole organ human pancreas tissue bank – QUOD-PANC.

The goal is to establish, curate and share a unique Bioresource representing the range of normality, acute stress and chronic disease within human pancreas – in parallel with access to detailed donor clinical data and quality-assured clinical pathologist reporting.

Integration with the core QUOD Biobank enables parallel access to donor circulating blood and urine samples in addition to small biopsies from other tissues.

The Portal provides access to organ donor clinical data in parallel with macroscopic and microscopic pancreas images. Multimodal samples from each anatomically defined region (8 in total from head to tail of pancreas) comprise: Formalin Fixed Paraffin Embedded tissue blocks (anterior and posterior) / snap-frozen tissue blocks / bulk protein samples / RNAlater samples / glutaraldehyde-fixed samples for EM. Sample details are catalogued for each donor.

Initial requests can be made through the Portal for samples to be processed centrally or released for approved research.

Researchers wishing to access QUOD samples should submit a preliminary registration online for Administrator approval and if successful submit a relevant project for review.

Contact us at atlasportal@ncl.ac.uk

For further information on the work being undertaken in Newcastle please go to Regenerative Medicine, Stem Cells, Transplantation | Faculty of Medical Sciences | Newcastle University (ncl.ac.uk)       

New QUOD Colleague Questionnaire – Kerry Clare

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Kerry Clare – Oxford Transplant Biobank (OTB) Coordinator & QUOD Oxford Regional Operational Coordinator

What were you doing most recently before joining QUOD and OTB?

I was working within the Oncology & Haematology department at the Churchill Hospital, Oxford as a Clinical Coordinator.

What interested you about working with QUOD and OTB?
I have previous experience with haematology and lab work and thought a role within a research biobank sounded interesting and rewarding.

What does your role involve?
I am the Senior Biobank Coordinator for OTB & QUANTUM biobanks and the Regional Operational Coordinator for the Oxford region for QUOD. I retrieve and process donor samples, ensure accurate entry of details into the respective biobank databases and am responsible for the smooth running of the sample collection and storage process.

Lightning round time:

If you were stuck on an island what three things would you bring?

My dogs, a fishing net and matches.

Where’s your favourite place?
Cornwall – many memorable family holidays.

Finally, what kinds of enquiries should people bring to you, and how best can they reach you?

Any sample collection and/or processing enquiries for OTB, QUOD and QUANTUM biobanks. Email kerry.clare@nds.ox.ac.uk.

Spotlight on a QUOD Colleague – Dan Eggleston

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For this edition of the QUOD newsletter, the spotlight shone on Daniel Eggleston who is a Senior Clinical Scientist within the field of Histocompatibility and Immunogenetics (H&I) at the Manchester Royal Infirmary and a Regional Operational Coordinator (ROC) for QUOD.

Dan’s first foray into the field of organ transplantation began following his undergraduate studies in Biochemistry at Royal Holloway University, where it became clear that he wanted to pursue the applied sciences more. He completed a master’s degree in Transfusion and Transplantation Science at Bristol University before joining Anthony Nolan, a charity dedicated to matching potential donors on a growing stem cell register to patients with blood cancer and blood disorders. The organisation also facilitates research working towards improving survival rates and quality of life after transplantation, providing post-transplant care.

When asked what advice he would give to any graduate students looking for a foothold in the applied sciences, which is often competitive as entry level positions are highly sought-after, he advised reaching out to relevant companies, making connections and being persistent. Dan also recommended tailoring the application to focus on experience garnered while completing University projects that are relevant to the skillset outlined for the position.  

As a Senior Clinical Scientist for a H&I laboratory, Dan uses Polymerase Chain Reaction (PCR) techniques to identify patient and donor Human Leucocyte Antigens (HLA) supporting organ transplantation (such as kidney, heart, lung, islet and pancreas), as well as stem cell and bone marrow transplantation, of which Dan is a donor himself. Dan can often be found on call, assessing the HLA type of a potential deceased organ donor, and creating a crossmatch or compatibility assessment to test if an organ from a potential donor can proceed to transplantation. Dan finds the on call work the most rewarding aspect of his role, though he has noted how challenging it can be during this time when balancing all the different offers of transplantation from potential donors across the country and trying to help as many patients and potential transplant recipients as possible following delays attributed to the COVID-19 pandemic. 

When not using his favourite piece of equipment in the lab, a PCR system for rapid cycling and tissue typing called the LightCycler, Dan supports the work of QUOD as a Regional Operational Coordinator (ROC) with Manchester being one of the regional centres for the biobank. This role involves taking receipt of QUOD boxes from the Manchester organ retrieval team, then centrifuging, aliquoting and freezing the blood, urine and bronchoalveolar lavage (BAL) samples, and shipping the box containing tissue biopsies to the hub at Oxford. Dan is also responsible for adding information from the QUOD worksheet to the QUOD database, which is integral for maintaining the traceability of the samples collected from a particular donor. Further to this, Dan has recently become the ROC representative on the QUOD Steering Committee. Part of this role is to provide feedback on research proposals submitted to QUOD. Dan remarked how interesting he finds this work as it shows where the samples, that he is involved in processing, are being used. He can then feed this information back to the team based in the H&I lab in Manchester, so they can stay well informed regarding the application of the biobank samples to current research.

In the last year, Dan has become a committee member for the British Society of Histocompatibility and Immunogenetics (BSHI), a national, professional body formed over thirty years ago that represents and supports the network of H&I laboratories across the UK. The objectives of the society are to encourage the advancement of scientific research and understanding of the application of these developments, as well as ensure the highest professional standards of competence are met by providing guidelines for best practice, training opportunities and CPD schemes for career progression. To this end, Dan has also taken part in a Higher Specialist Scientific Training Programme, funded by NHS England, all about leadership in healthcare. Dan also mentioned how he is looking forward to the next BSHI conference which is due to be held where he is based in Manchester next year.

Dan’s dedication and interest in facilitating transplantation research extends beyond his professional work, as he has helped raise money for Kidneys for Life, a Manchester-based charity which focuses on funding research into kidney disease, transplantation, in addition to supporting renal and transplant patients. Additionally, Dan took part in ‘Race for Recipients’ as part of National Organ Donation week, in order to raise awareness and to honour organ donors, recipients and those waiting for a lifesaving organ transplant.

Although he no longer captains a softball team in a charity league, which was a pastime during this time at Anthony Nolan, Dan likes to spend his spare time (when not on call) playing squash, going for a run or playing video games.

European Society for Organ Transplantation (ESOT) Congress September 2023

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QUOD attended the ESOT Congress in Athens, Greece from 17th-20th September. This biennial congress brought together over 2800 attendees from across the world and we were able to meet and connect with a wide variety of delegates from our exhibition stand. Importantly, research using QUOD samples was presented in over 10 oral presentations and posters during the congress.

Out of more than 1000 abstracts that were presented, the Liver Atlas study, carried out by Hussain Abbas at the University of Oxford using QUOD liver samples, was included as one of only 11 abstract presentations as a ‘Scientific programme highlight’ in the ESOT Congress review: “Development of a novel ‘Liver Atlas’ to predict pre-retrieval steatosis may help to avoid discarding liver tissue – A novel, large-scale ‘Liver Atlas’ developed in the United Kingdom supported the use of pre-retrieval steatosis predictors and routine retrieval biopsy to avoid unnecessary viable liver discards”. To find out more, see page 16 of the ESOT Congress 2023 Review.

Dr Ivan Hartling, from the Big Data Institute at the University of Oxford, attended the congress to present his work using QUOD samples. Please see his summary below:

The European Society for Organ Transplantation (ESOT) Congress was held in Athens, Greece from 17th – 20th September 2023. Additionally, on Saturday 16th, before the official start of the congress, there was an ESOT Science Day that featured a great series of basic science talks. The congress theme, “Disruptive Innovation, Trusted Care,” emphasized how innovation can improve access to transplantation.

Dr Maria Kaisar encouraged all our team members to submit abstracts to ESOT and travel to Athens. We were delighted that all our abstracts were selected for oral presentations and we were well represented at the congress. We presented a series of abstracts using QUOD samples to investigate how proteins in kidney donors associate with and predict kidney function post-transplant. Dr Philip Charles presented his work on “Age-Modulated Proteomic Signatures Of Donor Kidney Biopsies Associate With Below-Median 12 Month Outcomes”, Dr Sarah Fawaz presented “Circulating TNF-alpha levels in deceased donors associate with post transplant function in Kidney Transplantation”, Dr Ioannis Michelakis presented “TNF-α pathway activation on deceased kidney donors: a critical mediator of unfavourable post-transplant outcome”, and Rebecca Vaughan presented two abstracts, one titled “Changes In Endogenous Peptides In DCD Kidney Biopsies Associate With Prolonged Warm Ischaemia” and the other “Biological Injury Associated With Deceased Donor Pathways Reflect Differences In The Donor Kidney Proteome And Cellular Stress Responses”. 

I was honoured to have my abstract, “Identification of donor protein signatures that predict kidney transplant outcomes – ADMIRE study,” accepted as a late-breaking abstract. Both Dr Michelakis and myself presented in an early Monday morning session. Despite the early hour, the audience was alert, attentive, and asked many questions. 

As it was my first in-person conference in a few years, I was thrilled to have the chance to network with other researchers. The congress hosted a delightful wine and cheese evening, and throughout the event, attendees could mingle around the many industry and partner booths, including the QUOD booth staffed by Dr Sarah Cross and Philippa Wren. Overall, the congress was a great success, with excellent talks covering all aspects of transplantation. I am looking forward to the next ESOT congress, which will be held in London from June 29 to July 2, 2025.

The Evolution of a QUOD Box

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Bespoke, ergonomic and unique to the Quality in Organ Donation (QUOD) biobank, the QUOD sample collection boxes are critical to the transportation of donor blood, urine and tissue collected by nurses and retrieval teams. Sample collections are taken at four different time points across the donor management period, all the way through to the point of organ retrieval.

Manufacture

These custom-made sample collection boxes are assembled by hand and distributed nationally from the Oxford hub by QUOD Technical Assistant, Sophia Ali. Sophia joined the team four years ago and she continues to ensure that the Specialist Nurses in Organ Donation (SNODs) and retrieval teams across the UK are well-stocked with QUOD boxes, as well as other essential resources needed in theatre for sample collection. This can include biopsy punches and other equipment to aid in processing samples in the lab. “The most vital piece of kit which I am responsible for building and supplying across all hospitals in the UK”, she says, “is the famous QUOD box.” Watch a video demonstration of Sophia constructing a QUOD box [here] or read the step-by-step process from Sophia below.

How to build a QUOD box by Sophia Ali

“The QUOD box is made up of several components. You start with the outer box which is initially flat packed. Our vibrant QUOD sticker as well as the receipt and map sticker are applied. At the back of the box, we store the two information sheets, one for Scotland and one for England, Wales, and Northern Ireland along with the consent sticker.”

“Inside the box you will find individual red, green, blue, and yellow foams. Each foam represents a separate component and holds a different sample from the donor. The red foam will hold twelve blood tubes – six EDTA, three Heparin and three SST tubes. All are barcoded to identify the collection at separate time intervals. In the yellow foam you will find the BAL tube, three urine tubes and one (orange top) spleen container filled with RNAlater preservative. The green and blue foams contain the five tissue tubes. In the blue foam, the five tissue tubes are filled with formalin and the green, with RNAlater preservative. We currently collect liver, left kidney (in formalin), right kidney (in RNAlater), ureter, right heart ventricle and left heart ventricle. Each box will contain a worksheet where each sample collection can be recorded, and any variance notes can be added. There will also be DB1 and DB2 collection for blood serum in the preliminary stages of donation. Each box will be labelled with a unique barcode to ensure complete traceability. I also make note of where each box is shipped to via this barcode.”

Shipping

On a typical working day Sophia will respond to e-mail requests from SNODs and regional centres, subsequently building each QUOD box and packaging consumables accordingly, ready for shipping: “Due to demand, I have to make sure I have enough material to fulfil all requests. I aim to complete all requests within two working days”. During her time at QUOD, Sophia has calculated that she has built and distributed approximately 4,250 QUOD boxes since 2019! With the rising cost of consumables in recent years, the cost to produce and ship one QUOD box is currently around £60.00 GBP.

From retrieval to research

Tissue biopsies are stored in two different types of media for transportation to preserve the tissue in the best way possible whilst allowing for the widest variety of techniques to be carried out in future studies. Each sample has a unique identifying barcode which is recorded on the QUOD database to preserve traceability and donor anonymity throughout the whole process. The QUOD database links clinical donor information to these samples, allowing researchers access to samples that meet the requirements of their research.

Evolution

The current design represents years of continual evolution and improvement (as pictured), in accordance with changes to legislation from the early stages of QUOD to today. 2023 marks a ten-year milestone which we have honoured with a new logo that can be seen on each QUOD box.

Sophia remarks how the design is under constant review and has seen major changes in recent years, including changes to tissue collection and corresponding changes to the worksheet. Most recently being the change to kidney biopsies, whereby the biopsy from the left kidney goes into formalin, with the biopsy from the right kidney being preserved in RNAlater. Previously, biopsies from each kidney were divided in two, with each half going into formalin or RNAlater. There have also been changes to the sizes of heart and kidney biopsies over the years, in response to feedback from retrieval teams who collect the samples, researchers who use the samples and results from internal quality assurance audits.

A decade of QUOD marks a time of reflection for the whole team, as we look back on the evolution of the biobank over the last ten years and think about all the people who have helped us reach this landmark. We look forward to celebrating this achievement with our wider QUOD family throughout the year and most especially at our symposium on Friday 8th December 2023 at Exeter College in Oxford.