In March, Dr Ioannis Michelakis attended UK Kidney week in Harrogate, where he presented his work, which included samples from the QUOD Biobank. He sent us his report:
UK Kidney Week 2026 in Harrogate was a very interesting meeting, bringing together clinicians and researchers across nephrology to discuss recent advances in kidney disease. I had the opportunity to present our work from the University of Oxford in an oral presentation titled “Cystatin C vs Creatinine in deceased donors: drivers of the discrepancy between the markers and associations with post-transplant outcomes.”
The conference provided a valuable platform for exchanging ideas. I took part in a round table discussion on “Silent Signals: How Laboratory Medicine Reveals Renal Disease.” Overall, it was a very engaging and productive meeting with strong emphasis on collaboration and translational research.
In January, the QUOD team attended the NHSBT Clinical and R&D Conference 2026 in Birmingham. The two-day event brought together colleagues from across NHSBT to share developments in clinical practice and research within transplantation.
The conference opened with a plenary session featuring NHSBT Medical Directors, who spoke about blood and organ donation, with a strong focus on improving patient and donor outcomes. It was an engaging start that set the tone for a programme filled with insight, innovation and collaboration.
Throughout the conference, the QUOD team hosted a stand, providing a valuable opportunity to raise awareness of the QUOD Biobank, which is funded by NHSBT. While some attendees were already familiar with QUOD, many welcomed the chance to learn more about how we collect samples and the wide range of studies we support.
Across both days, we enjoyed connecting with colleagues from a diverse range of roles and disciplines, gaining a deeper understanding of the breadth of work taking place across NHSBT and the shared vision for the future of transplantation research.
In February, the QUOD team was delighted to take part in the Oxford Brookes Science Bazaar 2026 for the very first time. It was an impressive event, with an estimated 10,000 attendees, and the day brought together families from across Oxfordshire for an educational day exploring science.
Our team relished the opportunity to introduce visitors to the QUOD biobank, explaining everything from sample collection to the vital research it supports. The event was highly interactive, giving attendees the chance to see our bespoke QUOD box and even practise taking a biopsy (on apples!).
We were particularly impressed by the children who visited our stand. Many demonstrated fantastic knowledge of human anatomy, confidently identifying organs and where they are located in the body. “Paul” the life-sized torso was a big hit, offering visitors a hands-on approach to gain a deeper understanding of how our bodies are put together by removing and replacing his organs. There were also colouring in and word search activities, as well as a popular tombola, offering something for everyone.
We were also proud to showcase a selection of published manuscripts arising from studies supported by the QUOD biobank, highlighting the real-world impact of our work.
The day was a tremendous success, and it was a pleasure to meet everyone who stopped by our stand. A huge thank you to the organisers for hosting such a fantastic event. We look forward to returning in the future!
Live Life Give Life (LLGL) very generously provided pump-priming funding for two awards available to early career research scientists, clinicians, nurses, and allied health professionals. The funding was for UK-based studies and designed to help research projects generate preliminary data or support an ongoing research program.
The two awards were:
QUOD Impact Award The QUOD award will allow the researcher to access samples in the QUOD bioresource to use in their studies. The award covers up to £3.5k of samples, with a minimum of £2k to be used on samples and the remaining funds able to be used for analysis.
Open Discovery Award The second award is also for £3.5k and is to support early stage transplant research. There were no restrictions on applications for this award and it included quantitative and qualitative studies.
We received a strong set of high-quality applications that were assessed against several criteria, including project originality, potential patient impact, and prospects for clinical translation.
Six researchers were shortlisted in total, with three finalists selected for each award:
QUOD Impact Award
Christiana Lekka University of Exeter Inside the Pancreas: How Diabetes and Obesity Reshape the Organ
Sofia Kazerouni Newcastle University Validation of artificial intelligence (AI) models for macroscopic donor kidney assessment to support transplant utilisation decisions
Michael Corr Queen’s University Belfast Are plasma proteomic signatures at retrieval associated with early graft dysfunction in high risk deceased donor kidneys?
Open Discovery Award
Dhruv Satya Sahni Glasgow University A longitudinal cohort study of urological complications predictable by pre-transplant lower urinary tract symptoms (SCOPE)
Isaac Chung St George’s, London Investigation into differences in vascular biology of kidney transplant recipients and donors
Natalie Clark James Cook University Hospital, Middlesbrough Developing a tailored public health intervention for NHS staff: London
The final of the Innovation Competition took place at the BTS Annual Congress 2026 in Llandudno on 5 March. The judging panel, comprising Prof Rutger Ploeg, Ms Alison Smith, Mr Chris Callaghan, and Dr Luke Yates, were highly impressed by the exceptional quality of the proposed research, which made selecting the winners particularly challenging.
After careful deliberation, the winners were announced that evening at the BTS Gala Dinner. Congratulations to Michael Corr and Isaac Chung! We are delighted to support these research projects and look forward to seeing the outcomes of their work.
Our thanks also go to everyone who applied to the competition. We are incredibly grateful to Live Life Give Life for sponsoring the Innovation Competition, and to BTS for supporting the competition and hosting the final.
“Taking part in the Live Life Give Life / BTS / QUOD Impact Award competition was a fantastic experience. It was a great opportunity to present my research ideas and to hear about the innovative work being carried out by other early career researchers.
My research focuses on using proteomics to better risk-stratify higher-risk donor kidneys, with the aim of improving how we assess and utilise donated organs. Winning the award is incredibly encouraging, and the funding will allow me to access QUOD resources to help develop this work further and support the establishment of my research agenda as I progress in my post-doctoral career.”
A recent study by Sarah Fawaz and colleagues, led by Professor Maria Kaisar at the University of Oxford, used samples and data from the QUOD Biobank to investigate whether inflammation in deceased donors contributes to kidney injury before transplantation and affects graft outcomes afterwards. The study focused on tumour necrosis factor alpha (TNFα) and its receptors, TNFR1 and TNFR2, exploring both their clinical associations and their biological relevance in the donor kidney.
Kidney transplantation remains the best treatment for end-stage kidney disease, but the continued shortage of donor organs means that transplant teams increasingly rely on kidneys from deceased donors, which have more complex risk profiles. While routine donor assessment captures clinical factors such as age and comorbidity, it does not fully reflect the biological stress experienced by organs during donor management. In donation after brain death, this stress can include a pronounced inflammatory response — sometimes described as a cytokine storm — which may contribute to kidney injury even before the organ is retrieved.
To investigate this, the team quantified TNFα, TNFR1, and TNFR2 in 1,018 longitudinal plasma samples collected during donor management from 596 deceased donors (QUOD Biobank) and 34 living donors (Oxford Transplant Biobank). These measurements were linked to recipient outcomes, including graft function at 12 months and long-term graft survival up to 96 months. The study also incorporated matched donor kidney biopsies and mechanistic experiments in cultured human podocytes, allowing the findings in donor plasma to be examined alongside direct evidence of tissue injury.
The study found that high donor plasma TNFα levels were strongly associated with poorer kidney graft function at 12 months and up to 60 months, as well as reduced graft survival up to 96 months. Importantly, this signal was seen in donors after brain death, but not in donation after circulatory death, suggesting that the inflammatory biology of brain death may have consequences for kidney quality. These associations were confirmed in an independent validation cohort and remained robust after adjustment for donor and recipient variables.
Analysis of matched kidney biopsies showed that kidneys with high TNFα had increased expression of inflammatory and injury-related markers, including TNFR1, TNFR2, and caspase-3, together with reduced nephrin and aquaporin-1. This suggests damage affecting both the glomeruli and tubules. In vitro experiments strengthened this link further: podocytes exposed to plasma from donors with high TNFα developed an injury-associated profile, including activation of injury-related pathways, such as p38 MAPK and JNK signalling. This response was reduced by infliximab, which blocks TNFα, suggesting that TNFα-driven injury pathways may be not only measurable during donor management, but also potentially modifiable.
Together, these findings highlight donor inflammation as an important determinant of transplant outcome and suggest that inflammatory profiling during donor management could improve donor organ assessment. More broadly, the findings point to a clinically actionable window before transplantation, where targeting pathways, such as TNFα signalling, may help protect donor kidneys and improve long-term graft outcomes.
Summary
Using QUOD Biobank donor plasma and kidney biopsy samples, this study showed that high donor TNFα levels are linked to kidney injury and poorer transplant outcomes, particularly in donation after brain death. By combining clinical associations, biopsy findings, and podocyte experiments, the findings suggests that donor inflammation is both biologically relevant and potentially modifiable before transplantation.
These findings were published in the American Journal of Transplantation Feb 2026: DOI: 10.1016/j.ajt.2026.01.023.
For this issue of the QUOD newsletter, we are delighted to shine the spotlight on Amanda Gibson-Mills, Perioperative Team Lead for the Leeds National Organ Retrieval Service (NORS) team.
Amanda leads the liver transplant NORS and elective hepatopancreatobiliary (HPB) service within the Leeds Teaching Hospitals NHS Trust (LTHT), managing a team of around 40 staff, while remaining actively involved in clinical work. Despite the demands of leadership, she’s not one for sitting behind a desk all day and enjoys being hands on, supporting anaesthetics, problem-solving on the day, or heading out on retrievals with the NORS team. Amanda is also the lead Perfusion Practitioner for normothermic regional perfusion (NRP) and OrganOx normothermic machine perfusion. Leeds has recently established itself as an NRP centre, and she has been instrumental in setting up the service.
Amanda provides key support to the QUOD Biobank, coordinating sample collection by the Leeds NORS team. Her involvement begins with her team ensuring a sufficient stock of QUOD boxes and equipment, such as the centrifuge and biopsy guns, and checking the surgeons have everything they need to take the samples. She oversees the whole process, making sure samples are handled correctly, whether that’s reminding the team on the ground to centrifuge blood and urine samples or making sure the biopsies are collected into the correct storage tubes. Her role ends with the NORS team handing the QUOD box over to the QUOD regional lab team in Leeds when they return following the retrieval.
Amanda’s journey at LTHT spans an impressive 28 years, having started at the age of 18 as a Theatre Support Worker. LTHT offered her a secondment to train as an Operating Department Practitioner and she was awarded her diploma in 2008. During her training, a placement within the HPB liver transplant service confirmed to her that this was where she wanted to be. Through sheer determination and hard work, she worked her way towards leadership, shaping services and supporting teams through some of their most challenging times.
What drew Amanda to organ donation, and what keeps her there, is the ability to see the difference made to patients’ lives. She values the relationships built with the recipients and families, and the feedback that comes with hearing patients are doing well. Her first experience of organ procurement at the age of 19, supported by SNOD Julie Jeffries, opened her eyes to the wider impact of donation and transplantation as she vividly remembers hearing where all the organs had gone on to.
Amanda speaks about team culture with a real sense of pride. While she realises that retrieval work isn’t for everyone, many members of her team have been there for over 15 years. There is a strong emphasis on the importance of wellbeing, debriefing after retrievals, and mutual support, particularly on difficult days. She believes that compassionate leadership is essential, and staying connected to clinical work helps her remain grounded and attuned to her team’s needs.
Her leadership style has been shaped by role models, such as Cecelia McIntyre, then NORS lead in Newcastle, whom she met early in her career and who demonstrated that effective leadership and active clinical practice can go hand in hand. Amanda leads by example, encouraging openness, asking for help, and removing ego, reiterating the importance of positive leadership. She believes that creating a positive environment rolls out beyond the team and can make what can be difficult situations really positive. Little touches, such as having names on scrub hats and providing hot drinks and biscuits, to make sure everyone is looked after can have a hugely positive knock-on effect.
Reflecting on her career, Amanda feels she was always destined to work in a hospital setting. She fondly recalled weekends with her late father, who worked at the Leeds General Infirmary, helping him with his work from the age of 5. She has a sense that he helped to shape her career, with him spending time as a patient in some of the departments she later went on to work in. She feels incredibly lucky and privileged to work in transplant services and is proud of the Leeds team’s collective impact. Her journey is a powerful reminder of how dedication, compassion, and teamwork can transform both services and lives.
Outside of work, Amanda stays just as busy. Her 16-year-old son is 2nd Dan at kickboxing and her instinct to help and support others extends beyond the workplace to her son’s team, and she is actively involved with various roles, including facilitating on top tables doing scoring, ushering competitors to the correct mats, and making sure the referees are in place. Kickboxing has taken Amanda and her son to many competitions, both nationally and internationally, and she is excited for their upcoming trip to Abu Dhabi planned later this year. We hope Amanda also prioritises down time in her very busy life and can take time out to enjoy Abu Dhabi in the summer. We wish them all the best of luck!
QUOD is pleased to announce that applications for the Live Life Give Life / BTS / QUOD Innovation Awards are now open.
We are extremely grateful to Live Life Give Life, who have funded these awards. The idea is to provide pump-priming funding of up to £3500 to two projects. One project must include the use of QUOD samples, whilst the other can be on any transplant-related subject.
Shortlisted applicants will be invited to present their proposals at the BTS Congress 2026 in Llandudno on 5th March 2026, in front of a panel of judges and peers.
This is a fantastic opportunity to showcase your ideas, gain recognition, and secure funding to kick start your research.
To enter, download the application form below.
Applications close at 17:00 GMT on 30th January 2026.
QUOD attended Kidney Research UK’s Driving Discoveries conference in Bristol this September. The event was an excellent opportunity to connect with the kidney community and hear about the research being done as well as talk to researchers about how we can support their work.
Sam Tingle, Surgeon and Researcher in Transplantation at Newcastle University, sent us his report on the event.
“It was a pleasure to attend Kidney Research UK’s Driving Discoveries conference this year, which brought together researchers, clinicians, and patients to share new advances across kidney disease. I was honoured to receive the Best Oral Presentation Award for our work on using contrast-enhanced ultrasound to assess kidney quality during ex situ normothermic machine perfusion. Our study explores whether this imaging method can provide real-time insights into organ viability before transplantation. Our hope is that this will enable the transplant of kidneys that would otherwise have been deemed too high risk. The full paper is available open access in Transplant International.
A major highlight of the meeting was the strong focus on patient involvement; a theme woven throughout the sessions and discussions. The event reflected how collaboration between scientists, clinicians, and patients continues to drive meaningful progress in kidney research.”
Our Spotlight Interview for this issue of the QUOD newsletter features Prof Sarah Richardson, who took time out to talk to us about her research and her role within QUOD.
Sarah Richardson is Professor of Cellular Biomedicine at the University of Exeter and Steve Morgan Foundation Grand Challenge Senior Research Fellow, specialising in the pathology of pancreatic diseases, particularly type 1 diabetes (T1D). Her career began studying Molecular Biology at Sheffield University before moving into cellular biology, and most of her profession has been spent studying why cells do or do not die under certain circumstances, as happens in T1D with the destruction of insulin-producing beta cells.
In 2006, she entered the field of T1D and pancreas tissue research under the mentorship of Prof Noel Morgan, working as a post-doc and collaborating with Prof Alan Foulis at Glasgow University, who compiled the world’s largest collection of pancreas samples from deceased patients at onset of T1D. When Prof Foulis retired, the biobank (now known as the Exeter Archival Diabetes Biobank) was transferred to Exeter, where Sarah has worked on it ever since. Her journey towards her full professorship, which she was awarded in 2024, has seen her achieve various fellowships. She feels incredibly lucky to be able to study the rare pancreas bioresource at Exeter and to dig into what happens in T1D in humans, as there are so few samples around the world. The scarcity of pancreas samples stems from the fact that pancreatic tissue can only be obtained after death. The pancreas cannot be safely biopsied due to its deep location in the abdomen and the risk of digestive enzymes leaking and causing complications.
Sarah believes it is just as important to study organs from individuals without disease as those with disease. She is conscious that “we can’t understand disease until we understand normal”; however, the shortage of pancreases available to researchers is a barrier to increasing our understanding of normal. Sarah and her team study pancreases from healthy donors as well as those with diabetes or other pancreatic diseases. Her research uses sophisticated staining and imaging platforms to interrogate pancreatic tissue and employs AI-assisted imaging technology to deeply examine tissue across the entire pancreas. Scanning tissue sections across the organ, they are able to perform detailed analyses of entire images that would not be possible using a microscope. These techniques enable analysis of changes in the architecture of the pancreatic tissue across the whole organ with disease, as well as during normal, healthy development or with ageing, allowing them to pick apart changes within the pancreas that may influence the clinical changes seen in patients.
Sarah is currently preparing a publication with Dr Christiana Lekka from her team, detailing the setup of a pancreas bioresource website that highlights the different collections of pancreases available globally, such as the Exeter Archival Diabetes Biobank in the UK, Network for Pancreatic Organ Donors with Diabetes (nPOD) in the USA, the Alberta Diabetes Institute IsletCore in Canada, as well as QUOD’s Whole Organ Pancreas Atlas. At present, there are approximately 2,250 pancreas samples with and without disease available to researchers. While this may sound like a lot, it is important to consider the different types of disease each may have, which limits the number of samples available for use for specific projects compared with the numbers that would be obtainable for other types of study, for example, genetic studies that examine hundreds of thousands of individuals. There are around 400–500 samples from pancreases with T1D available around the world, and, of these, there are fewer than 100 samples available from individuals close to onset of the disease, which are important for studying the underlying disease process. Given the rarity of these samples, Sarah feels incredibly lucky to have collaborated with so many people across the world to try to translate the work that is often done in lab-based studies, such as in cells or mouse models, into human-relevant tissue to confirm that targets or pathways that may play a role in disease are altered in human tissue.
In addition to her involvement with the Exeter Archival Diabetes Biobank, Sarah has collaborated with Prof James Shaw at Newcastle University to develop QUOD’s Whole Organ Pancreas Atlas. This unique resource allows researchers to access detailed macroscopic and microscopic images from across entire human pancreases. The QUOD-PANC pathology core takes routinely stained sections from 16 regions across the pancreas and her team put these through an AI-assisted image analysis pipeline to extract detailed tissue information. This enables research into how the endocrine part of the pancreas changes, and allows quantification of fibrosis and fat within the tissue, which can be linked to donor diseases and lifestyle factors. Feeding the information from the organs into the QUOD Atlas enables researchers to accurately select the donors they want to use and ensures the best samples are used for studies.
Sarah describes it is fabulous to have this type of initiative in the UK. What makes it unique and special is the way that they are collecting tissue from regions right across the pancreas in a systematic way that allows pancreases from different individuals of different ages and with different diseases to be studied. Importantly, being able to examine the whole pancreas could shed light on diseases that may occur within different areas of the organ. This enables researchers to build a picture of the architecture right the way through the entire organ in a way that few other biobanks can offer.
Since she began working in the field in 2006, Sarah has seen a huge shift in our understanding of T1D. In 2025, teplizumab, the world’s first immunotherapy for T1D that delays onset in people at risk of developing the disease, was approved. This is opening the floodgates for more immunotherapies to come through as previously insulin was the only treatment for the disease, meaning the condition was only treated after it had developed. The work she and her team are involved with has helped to cement the need to develop these immunotherapies and now focuses on guiding their next phase. Her research could also inform emerging stem-cell-derived islet therapies. Sarah describes this as an exciting time for T1D research, noting the UK’s leadership in general population screening strategies and disease understanding, and with bioresources such as the Exeter Archival Diabetes Biobank and QUOD really helping to drive a lot of these strategies. While current new therapies aim to delay T1D, in future, it may be possible to prevent the disease.
A typical week for Sarah is filled with a diverse mix of activities, including one-to-one meetings with team members, writing and data analysis, planning experiments, collaboration meetings with people across the world, team meetings, lectures, conferences, and travelling. Her passion and enthusiasm for the work she does is clearly visible. Team science is important to Sarah and she relishes working with as many people as she can, helping to facilitate their research, often working to put a small piece of the jigsaw into the puzzle, which could be the icing on the cake in terms of translating lab findings to human relevance. She feels “lucky and blessed to work with many collaborators around the world” and describes it as a real team effort!
When not busy working, Sarah loves walking her Australian Kelpie, Mick (pictured). She can often be found walking round her local woods dictating or thinking through talks or presentations, and brainstorming how to communicate latest findings in an accessible way. She enjoys being in the outdoors, where she can allow her creative juices to flow, and says some of her best thinking time happens during her outings with Mick. She isn’t entirely sure what Mick makes of it, but perhaps he is taking it all in!
The process of death invokes a complex set of events leading to profound hyper-inflammation. Systemic hyper-inflammation is a well-established cause of organ dysfunction, evidenced by the multi-organ failure observed in sepsis. It is reasonable to infer that in deceased organ donors, death-induced hyper-inflammation could have significant consequences for organs being offered for transplant.
A study being carried out by PhD student Annie Mae Goncalves-Bullock and led by Dr Nina Dempsey and Prof Ascanio Tridente at Manchester Metropolitan University and Mersey & West Lancashire NHS Trust, is currently using QUOD blood samples from kidney donors to investigate the importance of donor inflammation on outcomes in kidney recipients.
There is already significant interest regarding the effects of inflammation on pre-donation organ viability, and the consequences for short- and long-term outcomes. Deceased donor management guidelines recommend high-dose corticosteroid therapy is administered to the donor as soon as possible after donor identification and confirmation of death. Corticosteroids are used in this manner to blunt the inflammatory cascade, stabilise donor physiology and increase organ utilisation. However, there is concern that the non-specific nature of corticosteroids means that inflammation persists in deceased donors and there may be significant room for improvement of protocols. A deeper understanding of the drivers of the immunological events that follow death is essential for the development of future donor management protocols.
The group is therefore measuring a wide panel of cytokines at three time-points during the donor management period (DMP) and working to establish their independent association with short- and long-term kidney transplant outcomes. Given the wealth of donor and recipient data QUOD can provide alongside samples taken across the course of the DMP, the group feels that the QUOD biobank is the perfect resource for answering such questions. The group has chosen to focus on the outcomes of kidney transplants since the kidneys are usually the first organ to fail in response to the renal medullary hypoxia and systemic inflammation present in sepsis, prompting the hypothesis that this would also be the case following death.
The donor sampling time points being considered are termed DB1 (shortly after donor identification and consent, allowing for capture of baseline inflammation), DB3 (at time of preparation for kidney retrieval, allowing for capture of biological changes from clinical interventions) and DB4 (at the time of organ retrieval, reflecting the donor’s condition at the final stage of the DMP). The primary outcome is delayed graft function (DGF), defined as need for dialysis within 7 days post-transplant. Other outcomes being investigated are high serum creatinine concentrations and low estimated glomerular filtration rate (eGFR) at 3- and 12-months post-transplant.
Despite standard DM protocols being used in these donors, the group is already seeing high levels of inflammatory markers persisting in these donor samples. It is hoped that the data from the study will support the growing evidence for revised immunomodulation protocols in deceased donors that are more targeted towards the initiators of the inflammatory cascade.
The PhD studentship is jointly funded by Manchester Metropolitan University and the NHSBT Organ Donation Fund.
Interim results from this study have recently been presented by the group at the British Transplantation Society conference, Brighton, March 2025 and the European Society of Intensive Care Medicine (ESICM) conference, Munich, October 2025.
