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!
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.
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.
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.
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)
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. You can find out who the finalists are here.
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
Azita Mellati
Necroptosis in kidney ischaemia reperfusion injury and the effects of a RIPK1 inhibitor in a preclinical model
Rebecca Vaughan
Prolonged fWIT is associated with metabolic dysregulation in DCD kidneys
Ioannis Michelakis
Plasma uromodulin dynamics in deceased kidney donors and the association with transplant outcomes
Posters
Alexander Daniel
Development of a magnetic resonance imaging protocol for ex-vivo assessment of deceased donor human kidneys
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 and pick up a QUOD pen. We would love to see you!
The final of the QUOD Innovation Competition 2025 will take place during the Young Academics Masterclass at the ESOT Congress in London on 28 June. 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 will compete for two awards of up to £5000-worth of QUOD samples for their research projects.
We are very excited to announce that the finalists are…
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
Thank you to Live Life Give Life and Alexion for sponsoring the Innovation Competition, and to ESOT for hosting the final.
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.
Our spotlight interview for this issue of the QUOD newsletter features Dr Sarah Cross, QUOD’s National Operational Coordinator. Sarah is based at the Churchill Hospital in Oxford and her role is central to the running of QUOD. She has a finger in many pies as she oversees the day-to-day operations of QUOD, including the core team in Oxford, and manages the ethics and regulatory framework under which QUOD operates.
When asked what a typical day might look like, she replied that every day is so varied and packed, which she loves, and there is no such thing as a typical day really. Each week, she catches up with the QUOD team members and senior management team. She is the first point of contact for all researchers who wish to apply to use QUOD samples. Her role involves liaising with researchers at the initial phase of application process, then coordinating and tracking the application process from beginning to end, when the researchers have received their samples, and then completed their studies.
Sarah attends many meetings and conferences across the UK as well as worldwide and is actively involved in public engagement and outreach to showcase how the QUOD bioresource supports research. These fundamental events allow QUOD to connect with the transplant research community and Sarah relishes the opportunity to meet up with researchers and colleagues old and new. The calendar for 2025 is filling up quickly and there are many upcoming events in March, including the BTS NHSBT Joint Congress and the QUOD annual symposium, which will be held in Birmingham and Sarah is responsible for organizing.
Sarah has always worked within transplantation and her first venture into this field began around 25 years ago during her undergraduate degree at the University of Bristol. Her final year project in a renal laboratory sparked her interest in immunology as she investigated the effects of immunosuppressive drugs on the release of proteins known as cytokines from immune cells that are found in the blood. Her project supervisor was a nephrologist who was also interested in pancreatic islet transplantation and this rubbed off on her. In 2000, the Edmonton Protocol was published in the New England Journal of Medicine by a team of researchers at the University of Alberta, Canada. This was a landmark paper that reshaped the entire process of islet isolation and transplantation and transformed outcomes. Following this, interest in the UK took off and the UK Islet Transplantation Consortium was set up, including centres at Bristol and Oxford. Based in Bristol, Sarah began her PhD in 2002, which looked at the impact of immunosuppressive drugs on release of vascular endothelial growth factor (VEGF) and its effects as a survival factor for pancreatic islets. This was an exciting time within the islet transplant world and Sarah relished the opportunities this brought, attending workshops, conferences and meetings worldwide, and she forged strong networks within the field.
Sarah’s PhD enabled her to gain invaluable experience isolating islets for research purposes, as well as involvement in setting up the clinical programme. She is proud of the work that came out of her PhD, which showed that the immunosuppressive drug sirolimus (also known as rapamycin, used in the Edmonton Protocol) reduced the release of VEGF from islets, impacting islet survival.
In 2006, the state-of-the-art Diabetes Research and Wellness Foundation Human Islet Isolation Facility opened at the University of Oxford. This happened just as Sarah was finishing her PhD, during which she had got to know the Oxford team well. Timings aligned as they were looking for a deputy lab manager, and so began her 14-year career in the Islet Transplant Research Group at the University of Oxford, leading islet isolation for transplantation, alongside further research in improving the islet isolation process.
In 2020, a career change called as QUOD were recruiting a new National Operational Coordinator. Sarah was aware of QUOD as they were located just along the corridor from the islet isolation lab and the move felt like the perfect transition towards facilitating a broad range of research across multiple organs within the field of transplantation. Sarah’s enthusiasm for her role within QUOD is infectious and she describes the work she does as her passion and she cannot imagine a more rewarding job. What brings particular joy is seeing the research QUOD is able to support and the scope for future projects, with many already in the pipeline.
“What makes QUOD special is that it is unique.” Sarah describes it as a privilege to be part of an established national programme that is supported by a host of transplant centres across the UK and work with a “huge family of people”, who work together to obtain consent and collect samples to ensure the success of QUOD, and then see the impact of the research carried out using these samples. It really is a case of bench to bedside, as the samples obtained from the donors can be used to generate data that can directly positively impact future patients to improve outcomes. Sarah loves coming to work every day and praises the entire QUOD team, from the core team in Oxford to the extended team around the country, as fantastic to work with.
Sarah is very much looking forward to the QUOD symposium as it offers the chance to bring together the extended QUOD family, and she is excited about being able to showcase the latest research outcomes from the bioresource samples and announce the plans and developments for the next 5 years as the QUOD team has been working diligently on their strategy to expand. It will be a great pleasure to have in-depth discussions and obtain input from all the groups involved within QUOD and thank everyone for their involvement and proudly exhibit the impact their hard work is producing.
When not working, Sarah cherishes time with friends and family. Her eldest son is a county footballer and she spends time supporting him and the teams in which he plays. In the past, Sarah has run several marathons, including cake-a-thons (marathons that involve eating cake en route!), and, while juggling family life means marathons are on hold for now, Sarah is keen to get back into running and muster a QUOD running team together to take part in the Donor Run, which marks the start of the British Transplant Games (BTG), which will be held in Oxford this summer. We wish Sarah and the team all the best for this event and hope that the BTG are a huge success.
