Joint BTS NHSBT Congress, March 2025

It was a pleasure to attend the joint BTS NHSBT Congress this year and present work from my PhD developing AI tools for photographic organ quality assessment. I spoke about our approach to segmenting donor organ photographs — using algorithms that isolate and quantify key anatomical features. This work, supported by access to imaging data from the QUOD biobank, is a step towards making AI models not just more accurate, but also more transparent and clinically usable. It was a great opportunity to share how this technology could support transplant decision-making, while also catching up with old friends, colleagues, and collaborators.

A big thank you to QUOD, whose partnership and support has been essential in making this work possible. Looking ahead, their plans to connect photographs with biobank samples opens up an exciting new chapter — allowing us to validate AI-generated insights against biological and molecular markers of graft quality.

Another highlight was the reception to our OrQA stand, where many transplant surgeons generously took the time to offer thoughtful feedback. This gave us valuable insight into how clinicians want AI tools to support their decision-making process — we’re very grateful for their time and input. And of course, the QUOD selfie frame made its way to us as well for a special guest appearance!

Blog written by Georgios Kourounis (OrQA)

World Transplant Congress 2025

QUOD is excited to be attending the World Transplant Congress in San Francisco this August!

We’re proud to have had the opportunity to curate a dynamic scientific session spotlighting the transformative power of bioresource and databank collaborations in shaping the future of transplantation.

Session title: “How to Optimise a More Global Research Infrastructure — Redefining the Clinical and Scientific Landscape in the Era of AI”

Time and date: Sunday 3 August at 14:15.

This session brings to the forefront the pivotal role of global research infrastructures and features insights from three leading biobanks:

  • Brendan Keating (USA) – iGeneTrain
  • Maria Kaisar (UK) – QUOD
  • Henri Leuvenink (NL) – TransplantLines

Following the talks, a panel discussion with additional experts will explore how strategic development of these infrastructures can accelerate innovation and precision medicine in transplantation.

If you’re attending WTC, we warmly invite you to join us for this compelling session — and don’t forget to stop by the QUOD booth in the exhibition hall.

Award-winning QUOD researchers shine at the European Renal Association Congress

Vienna hosted the 62nd European Renal Association (ERA) Congress from 4–6 June 2025, bringing together global experts to explore groundbreaking innovations in nephrology. The QUOD team was proud to see three researchers present findings from their studies using QUOD samples.

A special congratulations goes to Sarah Fawaz, whose work “Targeting TNFα signalling in deceased donor kidneys: A path to improve graft outcomes” was selected as one of only 100 “Best Abstracts presented by young authors”, placing her in the top 3% of submissions.

Rebecca Vaughan presented her work “Prolonged functional warm ischaemia is associated with metabolic and protease dysregulation in DCD kidneys” in the Kidney Transplantation session. Using QUOD kidney biopsies, her presentation sparked thoughtful discussion. She expressed gratitude for the support of NHSBT and the Nuffield Department of Surgical Sciences at the University of Oxford.

Ioannis Michelakis gave three talks, one of which highlighted important findings from studies using kidney and blood samples provided by QUOD. His presentation, entitled “Plasma Uromodulin dynamics in deceased kidney donors and the association with transplant outcomes” was well received by a captivated audience.

The QUOD team is incredibly proud to have supported these impactful studies.

Research highlight: Assessment of biological organ age using molecular pathology in pre-transplant kidney biopsies

This recent study using QUOD kidney samples by Roy Zhang and colleagues, led by Prof Menna Clatworthy at the University of Cambridge, reported a novel method for assessing the biological age of kidneys prior to transplantation.

The demand for kidneys for transplantation far outweighs the supply, leaving many patients, such as those with end-stage kidney failure, waiting for many years, during which their health may further deteriorate. To meet the shortfall, kidneys may be accepted from donation after circulatory death (DCD) donors or older donors, increasing the risk of delayed graft function (DGF) and poorer post-transplant outcomes.

At present, there is no reliable method for stratifying marginal donor organs. Zhang’s study addressed this by examining biopsies from DCD kidneys taken at the time of organ retrieval that went on to be transplanted. They aimed to characterise these organs to determine their “biological age” by identifying and comparing the molecular processes that occurred in kidneys with good and poor one-year graft function. They also investigated how donor age affects post-transplantation outcome.

Zhang identified distinct gene expression patterns in kidneys that developed DGF and poor graft function compared with those with good graft function, highlighting specific pathways as well as the presence of cell types that were associated with different graft outcomes. Gene set enrichment analysis showed that while immune pathways were enriched in kidneys with both high and low 12-month graft function, the nature of these pathways was very different. In particular, kidneys that showed good function at 12 months post transplantation, with a high estimated glomerular filtration rate (eGFR), were enriched for genes within the innate immune system, which is the part of the immune system that allows immediate response. On the contrary, kidneys with a low eGFR were enriched in genes involved in the adaptive immune system, which allows specific memory responses to be generated. More detailed investigation into the key genes driving this enrichment in kidneys with a poor 12-month graft function revealed upregulation of genes associated with T and B cells, as well as genes expressed in myofibroblasts and fibroblasts, which are cells known to be involved in forming scar tissue.

Histological analysis revealed increased fibrosis and interstitial lymphocytic infiltrate in kidneys with poor 12-month graft function, whereas samples with good 12-month graft function showed an increase in glomerular and tubulointerstitial neutrophils.

Specific genetic signatures associated with increased donor age and DGF and poorer long-term graft function (one-year eGFR) were also found. Weighted gene coexpression network analysis identified a gene module enriched for “allograft rejection”, which included many adaptive immune genes, and also various adaptive immune cell types, that was positively correlated with donor age and negatively correlated with 12-month graft function.

In brief, the study found that kidneys with good graft function showed acute inflammation and neutrophil/tubular signatures, whereas adaptive immune and fibrosis signatures were associated with poor long-term graft function. These findings have huge implications for kidney transplantation as identification of a transcriptional signature of organ “molecular age” in retrieval biopsies may assist decision-making around organ utilisation.

This study was published in Kidney International.

UKODTRN Transplant Registry Day

On 20 May 2025, QUOD was pleased to take part in an important meeting held in Birmingham by the UK Organ Donation and Transplantation Research Network (UKODTRN). The event, “Maximising the Research Potential of the UK Transplant Registry (UKTR): Barriers and Solutions”, was a great success, with excellent engagement from colleagues across the UK with an interest in transplant data science and enthusiasm to maximise the research output using UKTR data.

The meeting acknowledged the tremendous work done by colleagues at NHSBT to support current research efforts using the UKTR parallel to the specific focus on operational delivery work. Over the course of the day, with national and international speakers including Prof James Hunter representing QUOD, sharing their experience and insight, the meeting identified 10 key themes for improving the UKTR for the future. These focused on enhancing the access, quality, linkage, and breadth of the data, strengthening governance and IT infrastructure, securing specific funding to support research endeavours, and involving patients more meaningfully. Attendees emphasized that streamlining data access and improving linkage across existing silos would foster better clinical care, more robust research, and position the UKTR as a world-class resource. Patient involvement emerged as crucial, particularly in ensuring data reflects outcomes and experiences that matter to them. The need for clearer governance, public transparency in data use, and standardization of data input from hospitals were also discussed as strategic priorities.

To achieve these goals, it was acknowledged that the UKTR’s current structure—split across NHSBT teams without a central responsible body—limits its strategic potential. While some changes could occur without new funding, many proposed improvements, especially those involving IT improvements, more robust data capture, and enhanced artificial intelligence capabilities, would require significant monetary investment. Enhancing the UKTR would not only improve research output and attract industry investment/collaboration, but also support the implementation of national organ utilisation strategies. Overall, a unified vision and collaborative leadership across NHSBT directorates and commissioners are essential to modernising the UKTR. The UKODTRN will champion the need for strategic investment into the UKTR and will work with network partners to lobby relevant stakeholders.

Blog by Karen Rockell (UKODTRN Co-Director and PPIE Lead)

QUOD at ESOT Congress 2025

ESOT Congress 2025 is just around the corner, running from 29 June to 2 July.

Pre-congress activities kick off on 28 June and the highlight for the QUOD team is the QUOD Innovation Competition final. Six shortlisted finalists will take the spotlight during the Young Academics Masterclass, where they’ll pitch their research proposals in a bid to win one of two awards of QUOD samples, generously sponsored by Live Life Give Life and Alexion.

A number of presentations from researchers using QUOD samples also feature at the congress (see below). We’ll be sharing details of the scientific sessions on our social media channels during the congress, so do keep a look out if you are attending.

Oral presentations

Rebecca Vaughan
Title: Prolonged fWIT is associated with metabolic dysregulation in DCD kidneys
Date: Monday 30 June 2025
Time: 17:24–17:30
Session: Next-Generation Kidney Preservation | Donation, Preservation & Regeneration
Room: S5

Ioannis Michelakis
Title: Plasma uromodulin dynamics in deceased kidney donors and the association with transplant outcomes
Date: Monday 30 June 2025
Time: 17:18–17:24
Session: Next-Generation Kidney Preservation | Donation, Preservation & Regeneration
Room: S5

Azita Mellati
Title: Necroptosis in kidney ischaemia reperfusion injury and the effects of a RIPK1 inhibitor in a preclinical model  
Date: Tuesday 1 July 2025
Time: 17:06–17:12
Session: Unlocking Transplant Success: Biology, Engineering & Innovation | Donation, Preservation & Regeneration
Room: S3

Posters

Alexander Daniel
Development of a magnetic resonance imaging protocol for ex-vivo assessment of deceased donor human kidneys

Letizia Lo Faro
Plasma proteome during Normothermic Regional Perfusion show reduced complement and high detoxification level

And finally, we look forward to meeting with you at the congress, whether it be to talk about how QUOD can support your research, to reconnect, or just drop by and say hello. Visit us at the QUOD booth at stand F10, North Halls (Entrance N9 within the Society Village) and pick up a QUOD pen.

We would love to see you!

Full ESOT Congress programme

Spotlight on a QUOD Colleague: Prof James Shaw

For this issue of the QUOD newsletter, we spoke to James Shaw, Professor of Regenerative Medicine for Diabetes and Honorary Consultant Physician at Newcastle University, Lead of the QUOD Whole Organ Programme in Newcastle, and QUOD Steering Committee Chair.

As a diabetologist, James is hugely active with both clinical and research work, and divides his time equally between both. In the clinic, his main focus is patients with type 1 diabetes, particularly those who struggle to control their glucose levels. His responsibilities include patient education, mentorship of patients’ skills, keeping up to date with the latest technologies, and transplantation (islets and whole organ pancreases). James says it is an amazing time for diabetes as the field is rapidly evolving. He describes the ultimate goal as helping people to not need insulin and maintain good blood glucose levels without episodes of low blood glucose (known as hypos). “Diabetes isn’t a disease, it is a hormone deficiency, and it’s important to believe in the patients and support them.”

When he is not with patients, the rest of James’s time is spent researching diabetes, looking to better understand beta cells (cells within the pancreatic islets that produce insulin) and signalling from the pancreas to try to dissect out how stress signalling can lead to loss of function of these cells. In some patients, it may be possible to use other approaches to help their beta cells to work again, ultimately avoiding transplantation, and this is one of James’s areas of interest currently.

While James always knew he wanted to be a hospital doctor, he had imagined he would be a gastroenterologist or hepatologist. However, early in his career the opportunity arose to work with a fantastic mentor and endocrinologist, John Bevan, in Aberdeen. His venture into the field of diabetes and endocrinology coincided with the arrival of Kevin Docherty, whom he admired, who moved his group to Aberdeen, and it was then he undertook an MRC-funded PhD.

Following his specialist training and PhD in Aberdeen, James was awarded a senior fellowship from Glaxo Wellcome and moved to Newcastle. While he was a consultant at that time, his drive to move was partly motivated by the opportunity to continue to carry out basic science research. This gave him the flexibility to shape his clinical practice, setting up a pump service and working with the transplant team in Newcastle, who were beginning to transplant pancreases and introduce islet transplantation. James feels really lucky to have played a role bringing together the first UK islet transplantation centres and he still chairs the UK Islet Transplant Consortium. He considers it a privilege to have been a part of establishing the first adopted integrated pancreas and islet transplant service worldwide. James loves having the flexibility to support clinical programmes as well as everyone in the multidisciplinary team, allowing them freedom to learn by their own experience and support biomedical scientists. James describes his work as really rewarding, as his roles enable him to see the research from bench to bedside and back again. He has the advantage of being able to see both clinical and research angles, which can often be the hardest link to make. He is proud of his research team and takes great joy in being part of a team as a doctor and seeing the trials that have have come out of the scientific discoveries from his group.  

James’s involvement with QUOD first began with a conversation with Prof Rutger Ploeg, over the phone while James was rattling around on a train and struggling with signal. Despite conditions, he fondly recalled this as an “inspiring chat” about the opportunity to enhance the quality and scope of QUOD biobank. The pair communicated well, brought their different approaches to the challenge and worked to collectively bring together a successful MRC grant application. Their concept was to take untransplanted whole organs (starting with the pancreas) to build a wider, deeper tissue bank. This involved taking the whole organ to Newcastle and looking at its anatomy from the outside, then cutting sections and taking biopsies all throughout the organ. To date, QUOD has analysed 145 whole pancreases from carefully selected donors, and the programme is now accepting organs from donors with diabetes. The goal of this project is to begin to move away from exclusively transplantation related research, towards understanding ageing and chronic disease, such as diabetes. QUOD has collected these tissues “for the common good”, enabling access for researchers around the world.

James is proud of the initiative and believes that “QUOD is so successful because it is done by transplanters for transplanters” and there is a real investment from teams all across the UK. He is particularly impressed by how quality-oriented QUOD is, including the quality of the samples, as well as all the governance and the data, which he attributes to the “fantastic” hub and team in Oxford led by Dr Sarah Cross. Moving forward, he sees it as QUOD’s mission to make the non-transplant community aware of how successful this quality bioresource is and help them to tap into what he describes as this “marriage made in heaven”. He believes there is a lot of work still to do to disseminate the resource to the wider research community and go beyond simple transplant solutions.  

James’s role as Chair of the QUOD Steering Committee is to ensure there is transparency and clarity in terms of how the management group is working and what QUOD are up to and that this is disseminated, discussed, partnered, and coproduced by the stakeholders, comprising the teams at the QUOD regional centres, charities, experts by experience, lay stakeholders, and NHSBT. His role is to coordinate what he sees as an interactive discussion between all of these partners so that the core management group have oversight and everyone can have input and reflect. He assures that the QUOD team works hard to make sure everything is well run and everyone has a voice.

In March, QUOD held its 8th National Symposium, at which James chaired the final session and delivered the closing remarks. He has attended many QUOD Symposia over the years and feels it is an excellent stage to showcase the exciting developments coming from QUOD, especially for the people on the ground who are doing all the hard work collecting samples and consenting donor families. He describes it as the crossover between bringing together transplant science and clinical care and wider tissue-based clinical care and research. When asked about the future, James’s enthusiasm was clear as he revealed there are big opportunities in terms of larger datasets, exciting new science, the prospect of a national recipient bioresource, developments in organ perfusion and preservation, the introduction of organ ARCs (assessment and repair centres), and the role of QUOD within all of this. He envisages QUOD maximising the value of the resource rather than just turning the wheel. “The science is taking leaps and bounds and tissue-based research may lead to huge changes in donor and recipient management.” As Chair of the Steering Committee, he is excited to see that unfold and ensure that ideas are seen and shared. He also stressed the importance of hearing what the QUOD community would like to see happen in the future.

When he does get time away from his busy work life, James enjoys “simple things”, such as spending time with family and walking in the countryside (sometimes with a golf club in hand, although not recently). James also enjoys music and plays the guitar and sings, both as a hobby and as a member of a band. He describes his music taste as mostly 70s (Americana, Neil Young, folk music). What he enjoys most about being in a band is being more than the sum of the parts, and while he modestly describes his own performances as not the highest quality he also views that as part of the enjoyment!

QUOD Innovation Competition: The Final!

In February, QUOD launched the first QUOD Innovation Competition in partnership with the charity Live Life Give LifeAlexion, and the European Society of Transplantation (ESOT).

The final of the QUOD Innovation Competition 2025 took place during the Young Academics Masterclass at the ESOT Congress in London on 28 June.
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We received a strong pool of high-quality applications, which were evaluated based on criteria including originality of the project, patient impact, and clinical translation.

Six shortlisted researchers competed for two awards of up to £5000-worth of QUOD samples for their research projects.

The finalists were…

  • Peishan Wang
    Spatial-integrated temporal graph neural network model for early liver micro-injury and immunoabnormalities prediction in DCD liver donation
  • Maithili Mehta
    Decoding the Impact of cytosorb therapy during kidney normothermic machine perfusion using single-cell transcriptomics
  • Euan Bright
    The role of kynurenine 3-monooxygenase in preventing ischaemic cholangiopathy following liver transplantation
  • Sarah Fawaz
    Not all diabetic donors are the same: identifying differential risk profiles for transplant outcomes
  • Mayara Ramos
    Evaluation of the donor’s hormonal profile according to sex and age
  • David Baird
    Biomarkers of cell senescence and patient outcomes in kidney transplantation

The judging panel, comprising Prof Rutger Ploeg (QUOD Biobank), Karen Rockell (UKODTRN and QUOD Biobank), Dr Liset Pengel (Erasmus MC Transplant Institute), and Dr Luke Yates (Live Life Give Life), were blown away by the high standards of the research proposed.

After much deliberation, the winners were announced.

Huge congratulations to our two winners, David Baird and Euan Bright! We cannot wait to get started supporting your research and we patiently await the results.

A huge thank you to everyone who applied. We are extremely grateful to Live Life Give Life and Alexion for sponsoring the Innovation Competition, and to ESOT for hosting the final.

QUOD Symposium 2025

Prof Rutger Ploeg opened the 8th QUOD National Symposium on Thursday 27 March 2025 in Birmingham with a warm welcome, announcing that this would be his last as Principal Investigator before the handover of leadership in May to the QUOD Executives. The theme of the meeting was “QUOD’s vision for next 5 years” and he invited the audience to get involved with the discussions about where QUOD should go next in terms of expansion and new endeavours, such as partnerships with charities and industry, hearing and supporting patients, and how to improve QUOD’s visibility and increase sample use. Rutger thanked everyone in the extended QUOD team, including the NORS and regional laboratories teams and the core team in Oxford, for all their hard work before handing over to Chris Callaghan, Associate Medical Director of Organ Utilisation for NHSBT. Mr Callaghan opened the proceedings by congratulating the QUOD team on their “deeply impressive” success. He began by sharing the good news that NHSBT has agreed to fund QUOD for the next 5 years and shared an overview of how the transplantation arm of NHSBT can learn from their colleagues in blood donation, which accounts for the largest proportion of donations. He highlighted the need for diversification of the donor base and collaboration in order to join the dots and grow QUOD. James Hunter, QUOD Clinical Coordinator, followed on, presenting the “Vision to 2030”, with two main goals – increasing sample utilisation and ensuring financial stability – and outlining plans for four key innovations: a perfusate biobank, a recipient bioresource, a data library resource, and an enhanced whole-organ platform. Their enthusiasm and passion for what the next 5 years hold was compelling as the Symposium got underway.

Conversation

It all begins with a conversation. Organ donation would not happen without the sensitive work of the Specialist Nurses in Organ Donation (SNODs), who solicitously approach prospective donor families at an incredibly difficult time to talk about donation, not just for transplantation but also for research. Michael Gorton, SNOD Research Lead for the Midlands, spoke of what organ donation and fulfilling a loved one’s wishes to donate means to donor families, powerfully illustrating this with a personal account from a donor family. He also reported the statistics on organ donation, which show that around 6–9% of families who consent for donation for transplantation do not consent to the use of organs for research. It became evident during his talk that improving knowledge on research to the SNODS so that they can convey this information to the donor families is key to improving consent rates, and also that increasing the diversity of donors would be hugely beneficial to support studies into wider ethnicities, with the true gain being a better understanding of organs and improved outcomes for patients.

Collaborations and commonalities

It was clear throughout the day that a successful future will rely on and hugely benefit from collaborations. While this was emphasized across all of the sessions, it also became clear that there were many commonalities among the different groups across the transplantation community, who were brought together at the Symposium.

The industry panel discussion session showcased some of the strong links between QUOD and industry, with representatives from AstraZeneca, Argenx, and CardiaTec. The session highlighted the real need to identify emerging research needs and how industry and QUOD can help and support each other to work synergistically. The need for biobanks such as QUOD to increase their visibility to industry was noted and having a shared vision and identifying shared commonalities is of particular importance moving forward to increase science knowledge and improve patient outcomes.

QUOD is aware of the need to be prudent in ensuring the right research is being supported. Maria Kaisar, QUOD Scientific Coordinator, chaired the panel discussion on “Scientific Innovation Across Organs”. Sarah Richardson (Exeter) presented her work using whole pancreas organs to map islets in these organs from healthy donors as well as those with diabetes to understand the pathology of diabetes. Katie Mylonas (Edinburgh) described how she used QUOD samples to look at senescent cells in kidney disease and identify candidate markers of successful transplantation. Luke Williams (Cambridge) is studying biopsies from healthy hearts to look at primary graft dysfunction with a view to identifying potential therapeutic targets and Barney Stephenson (Newcastle) spoke about his research on liver transplantation, including ex-vivo normothermic liver perfusion and his involvement with the Organ Quality Assessment (OrQA) project. All four researchers demonstrated how the QUOD bioresource has supported crucial research across these different organs.

Luke Yates, Trustee for the charity Live Life Give Life, chaired the session highlighting the role of QUOD in supporting early career researchers and began by promoting the QUOD Innovation Competition, which is offering researchers the chance to win up to £5,000 of QUOD samples. Three early career researchers presented their studies involving QUOD samples, emphasising QUOD’s impact on education and career development.

In the session on the use of big data and AI, Lynn Morrice from Health Data Research UK outlined how they help researchers to access diverse and high-quality data. Following this, Colin Wilson, Principal Investigator of OrQA, talked about how big data is being used for AI in the OrQA project, which is supported by QUOD and uses images of livers and AI to score and predict outcomes of liver transplantation. OrQA aims to overcome human issues and reduce and avoid the rejection of organs, particularly livers, which may have otherwise gone on to be successfully transplanted.

While it was very much agreed that QUOD has supported a broad range of research projects in many different ways and that it is important to reflect on this, it was emphasised that the bioresource must not become a “stamp collection” and that there is so much scope for QUOD to grow. Prof Sir Rory Collins’ overview of the hugely successful (and huge in terms of its size and depth) UK Biobank really showcased the importance of duration and accessibility to be able to support more and more projects, while providing valuable insights that QUOD can learn from.

Celebrations and conclusions

The Symposium ended with celebrations of the success of QUOD to date and a reflection on the day, as the speakers and contributors were thanked. A special thanks and acknowledgement went out to Xiaohong Huang, regional laboratory lead at King’s College London, for over 10 years of service to the QUOD programme. She has worked tirelessly and diligently over the years and will be greatly missed by the QUOD team and we wish her a wonderful and happy retirement.

And finally, while this may have been Prof Ploeg’s last QUOD Symposium before he retires, it is evident that the future of QUOD is bright. Discussions flowed throughout the day, over coffee and lunch breaks, with new networks being created and connections forged. The QUOD team has clearly defined goals set for the next 5 years and a strong community of driven and ambitious members all working together, with a unified desire for success. What began as a vision more than 13 years ago has become Prof Ploeg’s legacy and is growing from strength to strength to support and advance organ research, ultimately improving patient outcomes.