Can we predict the results from an imperfectly matched transplant by measuring cytokines?
Researchers on this project will trial a new way to predict the compatibility between patients with blood cancers like leukaemia, and the family members who may provide stem cell transplants for them. Many patients who require stem cell transplants for blood disorders (known as haematopoietic stem cell transplants) do not have suitably matched donors, and their direct family members are often used as donors because they share at least half the molecules that need to be matching during transplant.
However, when an incomplete match, like a direct family member, is used as a donor, there is an increased risk of the recipient reacting against the transplant (known as Graft versus host disease). This problem can be fatal if it is not treated with potent drugs to suppress the immune system. Graft versus host disease starts when donor cells release chemical messengers (known as cytokines) that stimulate an immune reaction in the recipient. This study will compare the cytokines that are released by the cells from a number of donors with incomplete matches, and compare them with the transplant outcomes to see if pre-transplant cytokine responses may help doctors to select the best donor from available family members.
Eplet Compatibility and Lung Transplant Outcome – (HLA-DQA/B typing)
The success of lung transplantation depends on a close match between the donor and recipient to ensure the transplant is not rejected by the patient’s immune system. Before transplant, tissues are screened for a range of surface molecules known as Human leukocyte antigens (or HLA), and includes screening for a number of subtypes known as HLA-A, B and DR.
Antibodies generated against HLA antigens can lead to a condition known as Restrictive allograft syndrome (RAS). RAS has poor survival outcomes and may be related to antibodies generated against a type of HLA known as HLA-DQ, that is not part of the current screening protocol.
This project will combine testing for HLA-DQ antigens across a range of samples from past and future to determine if matching HLA-DQ antigens can predict post-transplant antibody responses and clinical outcomes, and provide evidence to support inclusion of HLA-DQ typing for future lung transplantation screening.