Costimulation Independent Rejection
Our lab played a key role in helping develop a new approach to transplant immunosuppression. Instead of giving patients drugs which have effects on almost all the cells in your body, we developed an approach that specifically targets the cells responsible for rejection. This more targeted approach has led to improved survival and kidney function for patients. We have observed that there is still a set of patients that experience rejection despite this therapy, and our current aim is to understand this "costimulation independent" rejection, and develop targeted therapies that prevent rejection altogether.
Transplanted organs are precious gifts. Organ rejection is a serious risk, and today, we are only able to diagnose rejection after it has already hurt the transplanted organ. Our lab is creating approaches, in collaboration with investigators at Georgia Tech, to detect rejection early, before it happens. We are creating a platform to detect rejection that patients can take home, and use weekly, so that every patient with a transplanted organ can monitor the health of their organ from home.
Everyone who needs an organ transplant today, does not receive an organ transplant. This means people are on an ever growing waiting list for life-saving organs, and everyday people die on that waiting list. Our lab is building on recent advances in genetic engineering and improved immunosuppression to create a scalable source of readily available organs for everyone on the waiting list. Our approach involves genetically engineering pigs and understanding the immune response to pig organs. We have had landmark success, with the longest recorded pig-to-primate xenotransplantation in history.
Transplantation is a team effort. Patients, families, donors, nurses, physicians, caregivers, scientists and surgeons all participate in the miracle of organ transplantation. We believe there is a responsibility to carefully measure how we are doing, and how we can do better. We carefully monitor how all patients treated at our center are doing, and use real-time data analytics tools to continue to improve our transplant outcomes, so patients live longer, healthier, happier lives.
To better understand where we are going, it's helpful to understand where our group came from. Chris Larsen and Tom Pearson built the Emory Transplant Center with a foundation in strong scientific investigation. Their seminal observations of the required costimulatory signals for alloreactivity (click here for article) launched numerous avenues of investigation and discovery, and culminated in the translation of a new strategy for transplant therapy - costimulatory blockade. Their leadership, then and now, in science, patient care, and continually improving processes push our lab and our group to do better and be better. More thorough perspectives on their journey and contributions are catalogued in open online publications here. The leadership team at our transplant center includes former trainees of the center, a testament to the excellence in training and the scientific experience. Furthermore, a number of faculty such as Dr. Ken Newell, Past president of the American Society of Transplantation, are involved in research and advisory roles. Dr. Mandy Ford, the current scientific Director of the Transplant Center and frequent collaborator has continued to make key contributions and elucidate mechanisms by which costimulation blockade and transplant tolerance work. Her work has grown to fields of autoimmunity, tumor immunology and sepsis. The transplant center has a vibrant history of prominent investigators who continue to enhance academic medicine and transplantation. These strong foundations allow us to continue to push into new frontiers in transplantation, with the hope of improving patient health and happiness.