ITHACA

• Research type

  Research Study

• Full title

  Immunology of THymectomy And childhood CArdiac transplant

• IRAS ID

  298986

• Contact name

  Simon Bomken

• Contact email

  s.n.bomken@ncl.ac.uk

• Sponsor organisation

  Newcastle upon Tyne Hospitals NHS Foundation Trust

• Duration of Study in the UK

  3 years, 11 months, 31 days

• Research summary

  Post-transplant lymphoproliferative disease (PTLD) is a potentially fatal cancer seen in children after organ transplant. In most children, PTLD is caused by Epstein-Barr Virus (EBV), which infects B-lymphocytes and is also known to cause glandular fever. These infected cells are normally kept under control by the immune system. However, the lifelong medication taken by transplant recipients to prevent organ rejection (immunosuppressants) also diminishes the control of this virus, leading to an abnormal accumulation of infected B-lymphocytes and
  their transformation into cancerous cells. PTLD affects approximately 1 in every 10 children within the first 5 years following heart transplant, representing a substantially higher risk than following other types of organ transplant. However, the reason for this increased risk is still poorly understood. We have previously identified that children with congenital heart disease are more likely to develop PTLD than children who develop an "acquired" heart disease. We believe this could be linked to their younger age at routine surgical removal of the thymus, a gland in the neck that is important for developing a healthy immune response to EBV.

  The research group has developed a collaboration with colleagues from Newcastle upon Tyne and Great Ormond Street Hospitals, through which we want to collect blood samples from 34 heart transplant patients and 6 kidney transplant patients just before transplant and at regular intervals over 2-years to understand how the age at thymus removal affects the immune system’s ability to fight off an EBV infection. This will involve measuring EBV antibodies, viral levels, and specific immune cells produced by the thymus against EBV. These experiments will enable us to understand how EBV evades the immune system to cause PTLD and determine new ways to improve outcomes for children with PTLD.

• REC name

  North of Scotland Research Ethics Committee 2

• REC reference

  21/NS/0142

• Date of REC Opinion

  15 Nov 2021

• REC opinion

  Favourable Opinion