Sensitisation in Kidney Patients – an Observational Study
Research type
Research Study
Full title
Exploring the Links Between Regulatory T cell Populations and Development of HLA Antibodies in Renal Patients Awaiting Transplantation
IRAS ID
276643
Contact name
Anthony Dorling
Contact email
Sponsor organisation
KCL
Duration of Study in the UK
2 years, 2 months, 24 days
Research summary
Kidney transplantation is the best treatment for most patients with kidney failure offering a better quality and longer life than the alternative options. Regrettably, half of all patients on the transplant waiting list are sensitised and so are disadvantaged. They are less likely to get a kidney transplant because organs are allocated to try and avoid the potential damage that antibodies can cause to the transplant, meaning they wait longer and are more likely to die while waiting. Even if they get a transplant, it might not survive as long because a sensitised immune system rejects organs more aggressively.
Crucially, not all people become sensitised when exposed to foreign tissues, but we don’t know why. Even less is known about why different causes of sensitisation (pregnancy vs. previous transplant) promote different problems. Unsurprisingly, there is no reliable way to prevent or reduce sensitisation.
Developing effective strategies to prevent sensitisation to HLA (Human Leucocyte Antigens) would improve outcomes for these patients in terms of immune matching and transplant longevity. This would in turn potentially increase availability of transplants to those at risk of dying on the waiting list.
To improve our understanding of how sensitisation arises we propose an observational study of patients with failing kidney transplants or previous pregnancies returning to renal replacement therapy and women with chronic kidney disease who become pregnant at Guy’s and St Thomas’ and King’s College Hospitals. The study will include collection of demographic data as well as blood samples for cellular and biochemical analysis. Surplus tissue after any transplant biopsies may also be analysed.
We envisage that this research will shed light on how sensitisation arises in these patients. Furthermore, it will inform whether future interventions based on boosting patients Treg numbers or suppressive capacity can prevent sensitisation to directly impact patient care.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
21/SC/0156
Date of REC Opinion
1 Jun 2021
REC opinion
Further Information Favourable Opinion