Spotlight on a QUOD Colleague

William Murray

This year, QUOD is celebrating its ten-year anniversary and for this edition of the QUOD newsletter, I was delighted to speak with William Murray who has been a Specialist Nurse in Organ Donation (SNOD) for NHSBT since the inception of QUOD back in 2013 in Edinburgh, Scotland. QUOD has now collected over 128,000 samples from more than 7,000 donors, supplying in excess of 38,000 samples to more than 55 research projects. This milestone would have certainly been insurmountable without the extraordinary efforts of this national consortium, including the Specialist Nurses who have such a critical role in the process.

William describes his role as a SNOD for NHS Ayrshire and Arran as multifactorial. He explains how the Specialist Nurses manage the process of organ donation from the point of referring a potential organ donor, working with colleagues in the intensive care units (ICU) and being present in theatre during retrieval. The SNODs are also responsible for the clinical management of the donor to ensure the stability of the patient all the way through the retrieval process through to family after-care. This includes speaking with the families or next of kin of the patient regarding consent/authorisation for research and the collection of samples for the QUOD biobank. William notes that the key to being a SNOD is communication, empathy, forming a rapport with people and using your instinct to judge what is right for every family member going through what is a very difficult time in their lives.

William explains how the respect and dignity to the families’ loved one is upheld and in the foremost thoughts of those involved during the process of obtaining samples for research purposes and that taking biopsies for QUOD does not affect the efficacy of the organs upon transplantation. Sample collection for QUOD closely mirrors the sampling required for the donation process and families are already aware that blood and urine is routinely analysed from patients while in hospital. William notes that the QUOD process works well because it has been built around the systems that already exist in the hospital.

When asked what advice he would give to any nurse or clinician considering specialising in organ donation, he advised to not lose sight of the unique relationship between the relative or next of kin and the patient, that the bond between a couple or parent and child does not change regardless of age and to be mindful of this.

The work that William does for QUOD is in fact a relatively small aspect of his day-to-day routine. He talks about how SNODs spend much of their time on call, covering the region that they work in which can often be a very large geographical spread. For William, this can include the whole region of Scotland! When not on call, William says that his focus is on teaching and raising awareness in addition to clinical audit and policy development. The latter includes identifying potential limitations or barriers to organ donation and working closely with clinical colleagues and committees to design and implement policies that address these barriers.

William remarked that change in his role is almost constant as incremental changes often occur on a weekly basis in reaction to clinical outcomes. William also discussed the interest in supporting organ donation and changes that he observed following the Government Campaign in Scotland, ‘Do Not Leave Your Loved Ones in Doubt’, which urged the public to register their decision with regards to the NHS Organ Donor Register and to speak about their decision with their families.

To close, William observed how being a SNOD is a complex role, helped by technological advancements with more information leading to better outcomes, very hard work but also incredibly rewarding; a unique position which gives him the opportunity to bring about meaningful change far and wide, and yet still work on a local level in the ICU, which is very important to him. He remarked how privileged he felt to work in a role that can help patients and their families across the UK, “What I do in Ayrshire, makes a difference at a national level”. Having started his career as an intensive care nurse, William says that “the intensive care unit is in my bones” and speaks warmly of the camaraderie and community embedded in the ICU and the connection amongst the SNODs.

A special thank you to all the SNODs across the UK, along with all the clinicians, retrieval teams, surgeons and technicians that have enabled QUOD to reach this monumental milestone!

William Murray was interviewed by Hannah McGivern.

Spotlight on a QUOD Colleague – Dr Bill Scott

For this edition of the QUOD newsletter, the spotlight shone on Dr Bill Scott who is the Scientific Director of Transplantation and Regenerative Medicine at Newcastle University, liaising with colleagues in all transplant specialities, orchestrating the daily running of the labs with a focus on moving basic and translational research into clinical practice. Bill is a key member of the QUOD hub in Newcastle, formed during the MRC funded expansion of QUOD to include whole organs made available for research. This important steppingstone will form the basis of many more research projects and enable access to bespoke samples to help answer burgeoning questions posed by the wider transplant community.  

Bill has spoken of his interest in improving access to tissue for research purposes, which has led to his collaboration with QUOD. He commented on how QUOD is uniquely positioned to address fundamental questions by facilitating access to blood, urine and tissue samples which are intrinsically linked to details of the donor. When asked what he thought was the biggest hurdle facing sample accessibility, he highlighted the importance of effective communication between all parties concerning consent and regulation at the start of the retrieval process. “As we leverage new techniques” he said, “we need to consider how we communicate this [information] to a lay audience”.

Bill has many more strings to his bow, which I was delighted to discuss with him. Originally hailing from the United States, Bill recalls his aptitude for maths at an early age, entering maths competitions when at school. He later undertook an undergraduate course in engineering at Ivy League University, Cornell, which also included core biology modules in addition to maths and engineering. These early studies underpinned his combined interest in medicine and engineering; after all, an engineer is adept at problem-solving, and throughout his postgraduate and doctoral training in Minneapolis in biomedical engineering, it became evident to him that the fundamentals of engineering could be applied to help solve problems in the clinical sphere. His interest was piqued by organ donation and transplantation research where there were, and still are, a number of issues to tackle, all with the common goal of helping clinicians and improving transplant outcomes for patients.

The NHS relies on companies making reasonably priced and accessible devices to help healthcare professionals deliver expert care to their patients. Bill highlighted the problem that many products are not affordable and are manufactured in the United States with the US reimbursement model, which differs completely from that of the UK and Europe. New devices developed on the back of high-quality research must serve real-world needs as well as make a profit for investors. Sounds like a tall order, right?

With this in mind, Bill took his years of research and learning a whole new vocabulary to approach and pitch to investors, sought to develop a device that could address key issues raised by the transplant community. At present, the demand for organ transplants far exceeds the supply, and current preservation systems rely on static cold storage which cannot be relied upon to keep the donated organ in optimal condition for more than a few hours. Methods that can sustain optimal conditions for prolonged periods of time are too large, complex and expensive. Bill, in collaboration with clinical engineers, software developers and investors, have developed the ScubaTx device designed to be fit for the real-world transplant environment and automate as much of the process as possible, while providing feedback on key events for the surgical team who can focus their attention on the transplant procedure rather than setting up a machine. Funds have been raised through Innovate UK and currently a number of prototypes are going to stakeholders across the world, with the hope that one day in the near future the device will be suitable for commercialisation. 

Over the years, Bill has also successfully acquired financial backing for several start-ups and research projects. When asked what advice he would give to early career researchers and future entrepreneurs looking to write their own grant proposals, he emphasised the need to just put yourself out there. “You miss out on 100% of opportunities you don’t try for, [and] it takes 100 times of repeating the same task to get good at something” he said. Essentially, persistence and resilience are key. Bill also advised to “not limit yourself to one funder” and take time to understand what motivates the funder, as they will each want something different. He continues by describing the continual evolution of a grant proposal, adapting to the feedback received and the importance of finding the right investors and stakeholders who share your vision.

Bill can often be found in front of an audience of another kind as he leads the MRes Transplantation course as a Senior Lecturer and Associate Professor. He says it is a very rewarding experience as he gets the opportunity to inform, inspire and foster greater progress and interest in the field in the next generation of nurses, healthcare professionals and researchers, all of whom form the backbone of the NHS. For Bill personally, teaching also gives him the chance to re-connect with his specialist field, to see the bigger picture and highlight problems that face the current generation.

When asked what piece of advice he would give to his students and mentees, he highlighted the importance of forming a narrative, regardless of whether you are creating a poster, presentation or producing written work like a grant proposal or manuscript, “if you do not tell a story, then you are simply stringing together a series of facts on the screen or on paper, expecting others to read the situation exactly as you do”.

When Bill is not teaching, presenting or working in the lab, he enjoys hikes in the countryside with his dogs and fishing, where he can embrace the tranquillity and explore the natural beauty of Northumberland.

Dr Bill Scott was interviewed by Hannah McGivern

Spotlight on a QUOD Colleague – Lewis Simmonds, Data Analyst QUOD

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This week I ‘met up’ with QUOD colleague Lewis Simmonds, of NHS Blood & Transplant.  Lewis is a statistician and provides QUOD with the data required for researchers.

Lewis joined the QUOD family in July last year after graduating from Bristol University with a First-Class degree in Maths and was given the task of streamlining the way QUOD’s data is gathered and extracted.

When a research scientist requests clinical data (for example donor, retrieval and recipient follow up data) to go alongside samples from QUOD, they must first select the data variables appropriate to their research question, which are listed on the QUOD website. This process then generates a spreadsheet that is communicated to our QUOD Data Coordinator here in Oxford, who then completes the data access request and sends it over to Lewis so that he can extract the requested data from the NHSBT database. 

When Lewis first joined us in the summer this process was rather lengthy and variables were colour coded into categories according to the lead times to receive the data, these were anything from under a month to more than three months.  This system has worked well until now, but as QUOD has become more well known, its activity has increased and the requests for samples have multiplied.  Lewis has turned this around by building a new database that produces the information easily at the click of a button, that will eventually be able to be run by any member of trained NHSBT staff within a much shorter timescale. It has taken quite some work to harmonise the data into a uniformly functioning format with fine tuning of the interactions between bodies of data but he says this work is almost complete. In just 6 months Lewis has transformed the process and QUOD is ready for action!  He will continue to work with QUOD to make changes to the website and before long researchers will be able to reap the benefit.

I asked him if he had learned his skills during his university studies.  He told me that he had learned Python, R, SQL and SAS, all of which are high level programming languages, at university but it is his fascination with how programmes interact with data structures and tables that led him to play around with programming in his spare time, testing his theories in developing games amongst other things.  His latest interest has expanded to website design and how the information that a website user taps into an interface is routed behind the scenes to create datasets, purchases, bookings or information collection.  He told me he has always been interested by how different systems can work together and loves exploring the possibilities to render systems compatible to a desired purpose. 

Lewis is based in Bristol and like a lot of us is still working from home though he enjoys going into the office one day a week.  The thing he likes best about his role is the creative freedom he has to seek out ways to improve systems and increase efficiency.  When he first took on the role, the biggest challenge was to familiarise himself with the many databases and their different properties in terms of function, formatting and location.

The most unusual thing Lewis has done in a job was when he was still at school.  As a fresh-faced sixth former he helped a friend run a mail/internet order business selling glowsticks, glow ears, flashing dog collars, baseball caps and light up bouncy balls!

In his spare time, other than tinkering with programming he is very keen on music with a particular penchant for Drum & Bass which has led him to DJing in and around Bristol on the weekends.  In lockdown he developed a taste for Hip Hop and Rap and he also enjoys cycling and a round of golf!

New QUOD Colleague Questionnaire: Philippa Wren – QUOD & Transplant Research Groups Administrative Assistant

In June, QUOD welcomed our new QUOD & Transplant Research Groups Administrative Assistant – Philippa Wren. Philippa has kindly agreed to share a bit more about herself and her role at QUOD:

Philippa Wren

What were you doing most recently before joining QUOD?
Surviving lockdown and home schooling my beautiful daughters, Grace 9, and Evelyn 2. My previous role involved PA, Administrative and Secretarial support for a Regional Manager. I also have a background in Marketing and Events organising.

What interested you about working with QUOD?
I have missed working within a team and hoped to work within a reputable academic organisation. I have always been fascinated with surgery and liked the thought of working somewhere that makes a difference. The two together seemed like the perfect opportunity for me..

What does your role in QUOD involve?
I provide administrative support for the QUOD and Transplant Research teams. I maintain the contact@quod inbox, social media platforms and website as well as take minutes for various meetings. I also place orders, liaise with suppliers of lab consumables and support Prof Ploeg’s EA in looking after his diary, organising his meetings and travel arrangements.

Lightning round time. Tea or coffee?
Tea – I love it!

Favourite place in Oxford?
There are so many. I would have to say the view of Oxford Skyline from the top of South Parks.

Best holiday trip ever?
Venice. There’s no other place quite like it.

Primary COVID-19 lockdown survival method?
Lots of long walks… and wine!

Finally, what kinds of inquiries should people bring to you, and how best can they reach you?
All inquiries are welcome. If I can’t answer it I can redirect you to someone who can. You can contact me via email contact@quod.org.uk or philippa.wren@nds.ox.ac.uk

Spotlight on a QUOD Colleague – Maggie Stevens

by Susan Patchett

For this edition of the QUOD Newsletter I was delighted to be able to catch up with Maggie Stevens, ODT Specialist Nurse for Research at NHS Blood and Transplant.  Maggie is responsible for the operational and service delivery for the great number of research studies that NHS Blood and Transplant operate and support alongside QUOD.

Hers is a varied role and involves setting up Specialist Nurse training, carrying out risk assessments for new studies, and helping teams draw up action plans and standard operating procedures (SOPS) ensuring that they comply with their ethics approval, regulatory requirements, and are fit for purpose for Specialist Nurses in Organ Donation (SNODs) to follow safely and effectively.

When I asked Maggie if she could describe a typical day she told me that there was no such thing.  One day she can be going through a risk assessment with the ODT Research Team and Quality Assurance for a large clinical trial and identifying potential operational, regulatory and safety risks.  Other days she will be auditing consent records to be sure all has been carried out to the letter.  She meets regularly with research leads in all the regions, ensuring they are up to date with studies that are being set up and also cascading training that they will undertake with their teams. 

Problem solving is a large part of her role and can range from SNODs raising issues if they aren’t comfortable with a particular process, to a shortage of boxes. 

Maggie works very closely with QUOD and helps us iron out issues that may arise in terms of sample collection, logistics, and other operational problems.  She forms the crucial link between QUOD and the SNODs.  After QUOD’s activity was paused during the first wave of COVID-19, she helped us with the mammoth task of restarting operations, updating SNOD training and finding ways around getting QUOD boxes delivered when so many personnel were working remotely between on-call shifts.

The elements of her job that she likes the most are the people and the research and innovation – ‘There is always wonderful new research going on such as the SIGNET trial and I find contributing to this work is really satisfying.’  She also said that her job is made very special by her colleagues, Hannah Tolley (OTDT Research Project Manager) and Emma Lawson (OTDT Innovation and Research Lead)). They work closely as a team linking in with other stakeholders to ensure that ODT research is facilitated safely and effectively. They also sit together alongside QUOD’s National Management Team.

I asked her if nursing was the career she had envisaged.  She laughed and said when she decided on nursing she was actually working at an agricultural college in Chelmsford, driving tractors and fruit picking.

Like all of us through the pandemic, Maggie has had to decamp her office to her home but she said she was one of many NHSBT staff who couldn’t bear sitting still when there were those working themselves to the bone on the front line so, she got herself deployed back to her original A&E department for six weeks.  She loved being back with her former colleagues.  I asked if she felt worried during that stint and she said ‘you just do what you have to do.’

Maggie Stevens is not all about work and loves an adventure in the great outdoors.  She has climbed Ben Nevis with colleagues for organ donation week and spent a couple of months travelling alone around Alaska where she saw whales and bears and met some wild and wonderful people that she will never forget.  She is also a fan of rock music and has tickets to see the Foo Fighters very soon!

Spotlight on a QUOD Colleague: Dr Maria Kaisar

by Susan Patchett

This time we will be getting to know Dr Maria Kaisar who is a scientist leading valuable research to identify biomarkers to better assess the quality of deceased donor organs.  She explained that biomarkers can be proteins or genes that can be measured during organ donation to indicate the risk of poor function or even failure after transplantation.  Her work also investigates biological processes that may be altered during organ donation and impact on effective organ function.  She says that the more that can be learned about the changes in biological mechanisms, the closer we come to designing new therapies to repair organs and make transplants last longer.

Dr Kaisar says she feels privileged to have been part of the QUOD team since its creation in 2012.  She recalls the strong collaborative spirit of the clinical teams (NORs, SNODs), academic partners and scientists across a host of institutions including NHSBT and transplant centres who all contributed to the development of the QUOD project.  She has watched QUOD evolve into the platform it has become today and takes great pleasure in seeing QUOD samples supporting so much exciting research both nationally and internationally.

Maria has also been working on the COMPARE Trial that showed that the addition of oxygen during hypothermic machine perfusion of older DCD kidneys improved transplant outcomes.  COMPARE is a component of the Consortium for Organ Preservation in Europe (COPE).

Every day is different for Maria as she spends her time in meetings, designing new experiments, analysing data and drafting grant applications and papers.  She splits her time between her lab at the NHSBT Filton Blood Centre in Bristol, where she has built a small team, and at the University of Oxford working alongside colleagues in the QUOD/Ploeg Research lab at the Oxford Blood Centre. She also holds responsibilities as Vice-Chair of ESOT’s (European Society of Transplantation) Basic Science committee. Working with colleagues from across the United Kingdom and further afield in the Netherlands, Austria, Denmark, France and Belgium has provided valuable friendships that extend beyond scientific interest.

Maria is a passionate advocate of the Women in Science initiative and diversity in science.  She says ‘We must rethink scientific careers to support career progression of scientists to senior leadership roles whilst caring for families – COVID has taught us that we can be productive in many ways and incorporate flexibility achieving a healthy work life balance. We also should aim to be more ethnically diverse as we can only gain valuable insights and perspectives’. The most significant obstacle faced by scientists today, she says, is the lack of long term, secure funding.  COVID has shown that investment in science is essential to meet the changing medical challenges we are faced with. 

Dr Kaisar’s journey in science began with her interest in biology at school, though she was also keen on philosophy, ‘very Greek!’ she laughs.  With a BSc in Chemistry from the University of Athens, she took up a one-year internship that became a six-year research role at Imperial College School of Medicine. After taking some time out to start a family, she returned to work for NHSBT and developed a strong interest in organ transplantation that led to joining Professor Ploeg’s group and completing a DPhil at the University of Oxford.

When Maria isn’t pondering science she loves holidays with her family, picnics, long walks and cooking.  She also loves live music and going to concerts and gigs which she hope to be able to do again soon.

Spotlight on a QUOD Colleague: Dr Hannah McGivern

by Susan Patchett

As part of our new series of spotlights on QUOD colleagues, I caught up with QUOD’s Tissue Handling Technician, Dr Hannah McGivern this afternoon.

Hannah takes receipt of and processes donor tissue samples; that is to say biopsies from both deceased and living donor organs, sent to us by QUOD hospitals up and down the country.  These samples are then stored in the biobank ready for researchers to apply for access to.

Hannah finds her work rewarding and relished the opportunity to learn the raft of new skills in soft tissue processing. She says that she feels privileged to collect samples in theatre for the Oxford Transplant Biobank (OTB), and to play a small part in this important moment in the lives of living donors and recipients. 

2020 has, of course, been a difficult year and the sudden and dramatic impact of the pandemic has been felt by everyone.  Hannah has also been working alongside QUOD colleagues to process plasma samples from individuals who have recovered from COVID-19 for the Convalescent Plasma Programme and for the new COVID BioArchive (COBA).  The pressure has been high in terms of the sheer volume of samples; the record was 300 samples processed in just one day!  Hannah feels honoured to be contributing to work that has the potential to have an important impact on the world; and on the future of biological science; ‘This is what every scientist dreams of.’  You can read more about COBA in our latest newsletter.

Hannah began working with us just over a year ago, during the final stages of her PhD at Cranfield University.  Her studies focussed on the structure and mechanical properties of the human skeleton.  She looked, in particular, at the ribs and clavicle and how their condition changes as we get older. Her work showed that our mechanical strength peaks in our mid-thirties before deteriorating.

Hannah’s interest in science began at the tender age of seven when her grandfather, an engineer in the Royal Air Force, described yeast as ‘little animals’.  At around eleven, her love of science was set in concrete when, at school, she came across a crime scene investigation kit which taught pupils the basic principles of forensic science, including how to take fingerprints. With her appetite whetted, she went on to study for a BSc in Archaeology with Forensic Science at the University of Exeter, followed by an MSc in Forensic Osteology at Bournemouth.

She has participated in archaeological digs as far afield as the USA and Iceland.  At Cranfield, she assisted with the cataloguing of human remains from a dig, colloquially dubbed Rat Island (Burrow Island), a tiny peninsula that juts into Portsmouth Harbour.  It is thought that the skeletons found there could be prisoners from the late 18th and early 19th centuries.  It was revealed that one may have undergone surgical experimentation, post-mortem, as the top of their skull had been removed.  The dig featured on ‘Digging for Britain’ a production for the BBC presented by Professor Alice Roberts.  Hannah is fascinated about what can be learned about the past from skeletal remains.  If you’d like to know more about this project click here.

Hannah is passionate about outreach work and contributes wholeheartedly to public engagement for QUOD.  In addition, she was selected to participate in Soapbox Science, an interactive outreach event to promote the work of female scientists. She is also a volunteer STEM (Science, Technology, Engineering and Maths) Ambassador going into schools to raise awareness of the careers available to women.  Having grown up in an area of the country  where the uptake of higher education is lower than much of the country, she strives to change preconceptions about female scientists and inspire young women to embark on careers they may not have deemed possible.  She is an avid supporter of the ‘Women in Science’ initiative and points out that QUOD, being staffed predominantly by women, is a perfect example.  You can read her blog by clicking here.

Though it is not all work, work, work for Hannah; she has a passion for literature and film, was an avid fan of Top Gear growing up and when she can, enjoys Latin and ballroom dancing.