research

Spotlight on a QUOD Colleague – William Murray

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This year, QUOD is celebrating its 10-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.

Announcing the ‘6th National QUOD Symposium’.

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We are excited to announce that the annual QUOD Symposium is back and will be held on Wednesday 9th November 2022 at Jesmond Dene House in-person, in Newcastle.

We look forward to having the opportunity to meet with the extended QUOD family based at regional centres and donor hospitals across the UK, as well as with researchers from academia and industry, and our NHSBT colleagues. Please see below for our save the date poster and latest programme.

If you are interested in joining us, please RSVP to quod-research@nds.ox.ac.uk

British Transplantation Society Conference 2022 debrief – by Azita Mellati

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After a year of virtual meetings and conferences, this year the British Transplantation Society (BTS) congress was again held in person at the ICC Belfast. The conference provided a great opportunity for clinicians and researchers to meet up and share the latest about their research and developments on their projects. Over the 3 days of the conference including 31 sessions, more than 100 talks were presented.

Our team from the Nuffield Department of Surgical Sciences (NDS) actively participated in the conference with a total 3 presentations and 1 poster. Dr Mohamed Elzawahry and Dr Letizia Lo Faro presented their research work on “Safety and feasibility of oxygenated hypothermic machine perfusion in the preservation of donor organs for pancreas transplantation” and “Normothermic machine perfusion of the liver supports protein translation and mitochondrial function while reducing protein degradation and metabolic imbalance: a proteomics study” in the “Dragon’s Den” and “Medawar medal presentations” sessions, respectively. The poster titled “Evaluation of kidney injury after treatment with CC-4066 during cold storage and assessment during normothermic reperfusion in a porcine ischemia reperfusion injury model” by Ms. Pommelien Meertens (as part of her Research Internship at NDS) was presented during the conference as well. I also had the opportunity to present my own research on “Investigation into the effect of Alpha-1 antitrypsin delivered via different preservation methods on ischemia-reperfusion injury in pig kidneys” as part of the “Science oral presentations” session. I received very interesting feedback on my project and had the great fortune to discuss details and plans with the audience and other attendees.

In addition to the scientific part of the conference, we also had the opportunity to enjoy and come together to celebrate the 50th Anniversary of the BTS. Over the course of the Gala Dinner themed “the 70s”, members shared good laughter and created wonderful memories. The conference also provided the opportunity to acknowledge and celebrate the lifetime of research work of several members of the BTS, including Professor Peter Friend from within our own department. Overall, this year’s BTS congress was a major success and a great sign that in person, scientific gatherings are back again for the better.

New QUOD Colleague Questionnaire: Dr Meng Sun – Data Co-ordinator & Analyst

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What were you doing most recently before joining QUOD?
Before joining QUOD, I was a genetics data analyst working at a public body following previous experience as a post-doctoral researcher at the University of Oxford.

What interested you about working with QUOD?
I have always liked working with data, databases and statistics. Being a data manager and having the opportunity to do research at the same time sounded like a good combination. QUOD’s position is also attractive because here we are working in an important area – organ transplantation. What we do really matters for patients.

What does your role in QUOD involve?
My main duties include managing databases for QUOD and OTB (Oxford Transplant Biobank) and their web applications, working with researchers on sample selection and data analysis. I also attend various meetings to provide statistics and advice related to databases and research.

Lightning round time:

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

  • a sharp knife for hunting and cooking;
  • a box of matches to make fire;
  • a tent to live in.

Where’s your favourite place?
Port Meadow, Oxford which is huge, a good place for running or just wandering.

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

Please contact me if you would like to know more about the samples we have in QUOD and how they could be used for your research. The best way to reach me is by my email meng.sun@nds.ox.ac.uk.

Spotlight on a QUOD Colleague – Dr Bill Scott

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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

QUOD’s recruiting!

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We currently have two exciting roles available to join our growing team…

Transplant Research Project Manager
Nuffield Department of Surgical Sciences, Oxford Transplant Centre, Churchill Hospital, Headington, Oxford.
Location: Oxford Transplant Centre, Churchill Hospital Site – Partial remote working is negotiableContract type: Fixed termHours: Full-time

About the role:
The Nuffield Department of Surgical Sciences seeks a proactive project manager to support the Professor of Transplant Biology, Rutger J Ploeg in the financial management, administration and development of his research project portfolio in the field of transplantation.

This role is a purely administrative role and does not require a scientific background. This post’s primary focus is on the co-ordination of deliverables and financial management of research projects and their funding from a range of sources including public and commercial funders. The post holder will provide Professor Ploeg and his Transplant Research Group with the oversight of project status, timeline and finances. In addition, they will help to identify funding from a range of existing sources to meet the activity and salary requirements for long and short-term projects. The post holder will support members of the Transplant Research Group with the financial aspects of their grant applications and awarded projects, and will help identify additional sources of funding for the Group. The post holder will manage the financial aspects of the existing QUOD Biobank programme and support new avenues of whole organ research by the QUOD Team.

You will be based at the Oxford Transplant Centre but partial remote working is negotiable. Tasks will include expenditure allocation, budget monitoring, coordination of grant applications and research contracts, yearly expenditure and progress reports to funders, organisation and taking minutes of research consortium meetings, project team meetings and following up on action points. You will liaise with NDS, Research Accounts, the Joint Research Office as well as Research Services for the development of new grants and contracts as well as day-to-day administration of expenses and orders.

About you: The successful candidate will be educated to degree level. Previous experience of financial planning and reporting, administration and project management, and demonstrable ability to confidently and effectively interact with a wide variety of stakeholders in multiple locations over a range of channels is essential for this role. Experience in medical sciences would be an asset. You will have excellent oral and written communication skills, with close attention to detail and the ability to adapt to a flexible working pattern, prioritise changing workloads, and meet tight deadlines. A proactive and professional attitude is a must. You will be computer literate and have experience of word processing, spreadsheets, databases, presentation software, and e-mails.

This full-time post is available immediately and is fixed-term until 30 June 2023 in the first instance, with the opportunity for an extension dependant on funding.

Application Process: Please quote reference NDSA853 on all correspondence. Only applications received before noon 20 October 2022 can be considered. For full details please visit Job Details (corehr.com)
Governance and Quality Manager QUANTUM Biobank
Nuffield Department of Surgical Sciences, John Radcliffe Hospital and Churchill Hospital, Headington, Oxford
Location: John Radcliffe and Churchill Hospitals (opportunity for occasional remote working).Contract type: Fixed term for 2 years in the first instance Hours: Full-time.

About the role: We are looking for a Governance and Quality Manager to join the Nuffield Department of Surgical Sciences, QUANTUM and QUOD Biobank teams, based at the John Radcliffe and Churchill Hospitals.

You will be part of the new UK Biobank, QUANTUM (QUAlity biobanking iNvesTigating Urological Malignancies). The biobank will serve as a sample-collection vehicle for our several nationally-funded collaborative trials (e.g. TRANSLATE, PART, PROMOTE, FINESSE) as well as translational research studies (e.g. SPACE, PROMOTE).

The postholder will need to work closely with the Chief Investigators and other senior biobank staff to establish a governance framework. This will include the coordination of the QUANTUM Management Committee, which incorporates biobank governance and tissue access committee, alongside quality management processes and documentation. Quality Management will include the management of records and controlled documents using a Quality Management System (QMS) but also the day to day management of quality issues, liaising with stakeholders to develop customer/stakeholder defined quality assurance, problem resolution and implementing change in relation to standard operating procedures and documentation. Once firmly established, the postholder will provide oversight and management of the QUANTUM QMS. This will involve managing audits and developing practices to fit with best practice guidelines.

This role will also expand the Quality Assurance team for the Quality in Organ Donation (QUOD) programme (www.quod.org.uk) and the Oxford Transplant Biobank (OTB). The postholder will help ensure that the QUOD and OTB Research Tissue Banks adhere to their regulatory and ethical requirements for existing and future projects. The role forms an integral part of the quality management process, by maintaining quality systems, which will include undertaking risk assessments and audits to ensure good governance is in place. The postholder will anticipate when SOPs should be introduced or updated, and ensure the provision of appropriate training. The role supports the QUOD and OTB Manager in ensuring that both Tissue Banks’ ethical approval is up-to-date and fit-for-purpose.

About you: The successful candidate will be educated to degree level and will have extensive experience working in an academic or clinical research environment. You will have excellent organisational and communication skills, and proven understanding of key legislation surrounding biobanks, clinical trials, ethically approved research studies and handling sensitive and confidential data, this will include the Human Tissue Act (HTA), Good Clinical Practice (GCP) and General Data Protection Regulation (GDPR). The post holder will also assist with maintaining and developing (writing and reviewing) SOPs for key aspects of the biobank (consent, sample access, import and export of samples, data security, storage and monitoring) to standardise such processes where possible. Understanding the way in which governance structures have moved from one study (ProMPT) to a biobank (QUANTUM) will be one of the key elements of succeeding in this role.
This full-time post is available immediately and is fixed-term for 2 years months in the first instance.  We would be willing to consider applications for part-time hours. 

Application Process: Please quote reference NDSA860 on all correspondence. Only applications received before noon Thursday 20 October 2022 can be considered. For full details please visit Job Details (corehr.com)

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!

QUOD named UK Biobank of the Year 2022!

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The UKCRC Tissue Directory and Coordination Centre awarded QUOD first place in the UK Biobank of the Year.

The UK Biobanking Showcase is the UK’s leading event for those who work in biobanking and human tissue research and took place online over three days with interesting talks and presentations from biobanks all over the UK.

Please see below some extracts from the Judging Panel’s comments: 

‘… the Biobank provides a highly specialist resource which is of immense value to the organ donation field.  Despite being so specialised, … QUOD nevertheless responded flexibly during the pandemic to participate in the RECOVERY trial and in the development of the NHSBT Oxford COVID BioArchive (COBA).  …  The panel particularly commended the quality and range of the Biobank’s outreach and engagement activities which unusually included providing work experience to college students during the pandemic.’

Professor Ploeg, Director of QUOD (Quality in Organ Donation) and Dr Sarah Cross National Operational Coordinator of QUOD are delighted with this wonderful achievement: ‘This award is an important milestone in our pursuit to increase research in donation and transplantation, increasing organ utilisation and providing more and better organs for our patients’. They congratulate the whole QUOD team including the Specialist Nurses in Organ Donation and NORS teams based in the 61 NHS partner trusts across the UK, as well as the core team in Oxford, the Directors of NHS Blood and Transplant, the Medical Research Council and our academic collaborators without whom none of this would have been possible.

Dr Maria Kaisar – Developing new ways to assess kidneys so transplants last for longer.

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With funding from Kidney Research UK, a team of researchers from the University of Oxford, the University of Nottingham and University College London will develop ways to assess donor kidneys and predict how well they will work after transplant.

Having a kidney transplant is the best treatment for kidney failure, but the demand for donated kidneys is high.

To save more lives, doctors are now accepting kidneys from older or higher risk donors. These kidneys may also work less well after transplantation. This can have devastating effects, causing patients once recovering from transplantation to also go back on to dialysis, and wait for another transplant.

Right now, doctors cannot accurately assess donor kidneys. This makes it difficult to predict how well a transplant will work and how long a kidney will last after it has been transplanted.

Thanks to Kidney Research UK’s grant award of £237,626, (in partnership with the Stoneygate Trust), the ADMIRE study ‘Assessing Donor kidneys and Monitoring Transplant Recipients’ aims to address this clinical challenge.

Dr Maria Kaisar

Dr Maria Kaisar from Oxford University’s Nuffield Department of Surgical Sciences (NDS) is the Principal Investigator on the study and leads a team of co-investigators from NDS (Professor Rutger Ploeg, Dr Edward Sharples, Mr Simon Knight, Mr James Hunter and Dr Sadr Shaheed), the Oxford Big Data Institute (Dr Alberto Santos Delgado and Dr Philip Charles) and the Radcliffe Department of Medicine (Dr Elizabeth Tunnicliffe). 

Dr Maria Kaisar and her team will utilise the Oxford Transplant Biobank (OTB) and the Quality in Organ Donation (QUOD) biobank to look for marker proteins in the donors’ blood samples. They use these samples to develop a mathematical model to predict how well donor kidneys will work after transplantation. The successful model would allow doctors to accurately assess kidneys and only transplant those that will function well. It could also identify suitable kidneys previously deemed too high risk to transplant.

With Professors Sue Francis and David Long from the University of Nottingham and University College London, the NDS team will use the QUOD X platform to also develop a monitoring strategy. MRI scanning methods will be performed on both the donor organ before it is transplanted, and later on after transplantation. This will allow us to monitor how well the transplanted organ is functioning.

“I am absolutely delighted that our study received this funding award by Kidney Research UK in partnership with The Stoneygate Trust,” said Maria. “This funding will enable us to bring scientific and clinical expertise together in collaboration, to develop novel non-invasive methods to better assess donor kidneys and, predict how well a transplant will work in the recipient. We also envisage that our planned scientific work will offer many opportunities to our early career scientists, to further develop their skills and research expertise in studying kidney disease. “

Letizia Lo Faro – Use of QUOD samples in research ‘Case Study’

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My name is Letizia Lo Faro and I am a Post-Doctoral research scientist in the Oxford Transplant research group. I have so far used QUOD samples in 4 or 5 separate research studies. In one of these, conducted together with Ms Flavia Neri (University of Padova), we were interested in studying the molecular features of donor kidneys with acute kidney injury (AKI) having different functional outcomes after transplant.

Letizia Lo Faro

Once we fully characterised our research question, we moved onto donor sample selection. We decided to compare 4 different groups of donors: with or without AKI and each with good (≥45 mL/min) or poor (<45 mL/min) function (eGFR) 12 months post-transplant, for a total of 40 donors. We maximised the difference between outcomes as much as possible and to allow for fair comparisons we decided to match the groups for several other variables (donor age and gender, BMI, cold ischaemia time, recipient age, recipient gender…just to name a few). I believe appropriate sample selection is a key step in such retrospective studies and we engaged with the QUOD Data Manager earlier on in the process. This provided us with a great overview of all the variables available and also made sure our groups were nicely balanced.

Once we were happy with the donor selection, we proceeded with requesting the samples from the biobank. In this case they were full RNAlater frozen kidney biopsies and formalin-fixed paraffin-embedded (FFPE) kidney tissue slides. In this study we were interested in studying protein expression, so first of all we processed the tissue biopsies to mechanically homogenise them and extract the proteins. Later on the proteins were quantified and the expression of 17 proteins of interest was analysed by Western Blotting (a technique where a mixture of proteins is separated on a gel, based on the molecular weight, and, following transfer on a membrane, proteins of interest are identified by binding to specific antibodies). Results were then analysed with statistical tools.

A set of FFPE slides was then utilised for histological assessment, by standard staining with haematoxylin and eosin (H&E), to quantify chronic and acute tissue damage. One additional set of slides was utilised for confirmation of the western blotting results by immunohistochemistry, another method which allows to check for the presence of certain proteins/products in a tissue, by binding with labelled antibodies.

Results from this study were presented at the British Transplantation Society meeting last year and we are currently finalising a manuscript for publication.

Our results suggested that specific molecular patterns are recognizable in acutely inured kidneys that proceed towards worse function after transplantation. In particular, Peroxisome proliferator-activated receptor gamma (PPAR gamma) specifically increased after acute injury that progressed to worse function, underlining a potential role of metabolic dysfunction in the development of kidney disease (Figure 1).

Figure 1. The protein PPARg, quantified by western blotting analysis, is significantly increased in AKI kidneys with poor outcomes 12months post-transplant.

Our findings have helped identify potential molecular mechanisms involved in the progression of acute kidney injury to chronic kidney disease and post-transplant dysfunction and may constitute a therapeutic target of further interventions aimed at improving the quality of donated kidneys with an acute injury.

Working with QUOD samples has allowed us to really dive deep into the study of molecular mechanisms of kidney injury and the availability of different sample types also allowed us to apply various techniques and methods to validate our findings.