Medical Reading. Your HealthGuard.

Renal Professor In Call To Broaden Research Into Long-term Kidney Transplant Failures

April 05, 2017

Around half the number of patients who receive kidney transplants reject the organ after 10 to 15 years and need to go back to dialysis treatment, as the chances of accepting a kidney from a second transplant are reduced.

Now Renal Consultant, Professor Magdi Yaqoob, writing in the current edition of the highly acclaimed New England Journal of Medicine, says current research needs to shift its emphasis from concentrating on specific proteins as the cause of long-term renal failure to a much broader base in a bid to help cut long-term renal failures after transplant.

Prof Yaqoob, Professor of Nephrology and Renal Consultant at Barts and The London NHS Trust conducted a study of over 1,100 renal transplants which showed that gene regulation of a single process, such as complementary proteins, plays no role in long-term outcomes for kidney transplants. This observation is highly significant because, until now, the widely-held view has been that this process in fact plays a major part in long-term outcomes.

Prof Yaqoob said: "Even though the results of the study we did into three different genetic types are essentially negative, they highlight the complexity of the process that leads to long-term renal failure.

"In the UK between 500 and 800 people per million of the population suffer from end-stage kidney disease. Most of these patients survive through artificial kidney treatment, such as dialysis, but the best treatment is kidney transplantation. Staying on dialysis significantly diminishes life expectancy, whereas transplants lead to a longer life. Unfortunately, the availability of suitable kidney donors is not matched by demand which is rising at a rate of around 10% every year.

"The widely-held view is that certain proteins play a part in the late rejection of kidney organs after transplant. But the research we did contradicts this and points to other factors and multiple pathways - namely, that if kidneys are matched beneficially at a genetic level, kidney outcome may improve.

"It is clear many biological processes come into play in the build-up to long-term kidney rejection - it is these multifaceted processes and pathways, and a broader base, from which tomorrow's research must start."

C3 Polymorphisms and Allograft Outcome in Renal Transplantation by Mira Varagunam, Magdi Yaqoob, Bernd Dohler and Gerhard Opelz is published in the New England Journal of Medicine.

- Barts and The London is one of Britain's top teaching hospital trusts. Our mission is literally to bring excellence to life - to give patients the best possible care so that they can live better, fuller, longer lives.

- Our world-renowned hospitals - St Bartholomew's (Barts) in the City, The Royal London in Whitechapel and The London Chest in Bethnal Green - have made and continue to make an outstanding contribution to modern medicine. Read more about our full portfolio of services at bartsandthelondon.nhs.

- Barts and The London Renal Centre is based at The Royal London in Whitechapel, east London. It has a dialysis unit at Barts Hospital in the City, and offers renal services at Whipps Cross Hospital and Queen's Hospital in Romford, Essex and at Newham University Hospital in east London. It provides the full range of renal treatments for patients living with kidney disease. This includes dedicated clinics for chronic kidney disease (CKD), haemodialysis units, peritoneal dialysis units and a transplant unit. More information can be found at bartsandthelondon.nhs/renal/

- Our £1 billion new hospitals programme is set to transform healthcare facilities locally. When completed the new hospital at The Royal London will be the biggest new hospital in the country, while the new buildings at Barts will house a brand-new cancer hospital and cardiac centre.

Barts and The London Renal Centre