Transplant Research Leads to Better Outcomes
September/October 2008
As a result of research initiated at Penn and carried into practice, more
patients considered to be at high risk—those with severe heart, kidney, liver
and lung disease—are surviving end-stage organ disease than ever before.
Transplant Research Advances at Penn
Penn is a
leading center of transplantation research, as
well, achieving continuous NIH funding for
more than 30 years.
This unique combination
of clinical and scientific excellence reinforces
the center's desire to provide the best for
transplantation patients by
translating advances in
science into progressive
clinical care.
Among the Institute's
broad-based initiatives, the
following ground-breaking
areas of investigation are
noteworthy for their recent
contribution to transplant
research:
Immunological Monitoring: Discovering
New Pathways to Predict Organ Rejection
Penn Transplant Institute
Director Abraham
Shaked, MD, PhD, is leading an
NIH-funded study of kidney donors to
determine whether acute rejection can be
predicted by sequential mRNA profiling of
urinary cells. Secondary goals of this study
include determining whether pre-emptive
treatment based upon mRNA profiles can be
used to prevent acute rejection and preserve
glomerular filtration rate and whether these
mRNA profiles can be used to guide the
withdrawal of calcineurin inhibitors in stable
recipients and other aspects of immunosuppression
management.
Exploring pathways of
injury can identify an organ at risk of failure
and lead to improved treatment strategies.
Currently, 10 to 25 percent (depending on the
organ) of all transplant recipients experience
abnormal function of the organ that can have
an impact on long-term organ rejection.
Mechanical Assist
Devices: A Bridge to Transplant
In 1975, Penn participated in the groundbreaking
NIH-funded multi-center study that
first explored sustained heart bypass for
patients with devastating heart injuries. Since
this time, Penn has been at the vanguard of
mechanical assist device technology research
to support patients awaiting transplant. Each
year, these devices help up to 30 percent of
waiting individuals survive long enough to
receive a new heart.
The Penn Transplant Institute was the first
in the Philadelphia region to send a patient home
with a Left Ventricular Assist Device (LVAD)
system – and the first hospital in the Northeast
United States to implant the temporary Total
Artificial Heart (TAH-t). Research has shown
that patients receiving the TAH-t have almost
twice the survival rate versus patients who
received standard ventricular assist devices.
Penn researchers are now studying a new
portable device driver which would allow
TAH-t recipients to return home while they
wait for transplant.
Living Donor Liver Transplantation:
Improving the Odds
The Penn Transplant Institute is one
of nine centers participating in a National Institutes
of Health (NIH)-funded multi-center study of
adult-to-adult living donor liver transplantation.
The Adult-to-Adult Living Donor Liver
Transplant Cohort Study (A2ALL) investigates
the experience of a group of patients eligible
for living donor liver transplantation, focusing
on the factors influencing outcomes of living
donor liver transplants for both donors and
recipients. Researchers will compare outcomes
of this new procedure with the outcomes
for patients who receive livers from
deceased donors.
The Penn Transplant Institute performed
its first adult-to-adult living donor liver
transplant in 1999. The liver transplant team,
led by Kim
Olthoff, MD, is currently studying
liver function and liver regeneration in
transplant recipients and donors following
surgery, specifically the effects of anti-rejection
therapy and gene therapy. The results of this
extended study will give liver transplant
patients and potential donors solid information
about the risks and benefits of this innovative
and sometimes controversial procedure.
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or refer a patient, contact PennHealth through the secure online
referral form or by calling
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