The pages below give an outline of the research being undertaken by the kidney units at Guys and St Thomas’ NHS Foundation Trust and King’s College Hospital Foundation Trust.
Translating research into improving health and well being
Research at Guy's and St Thomas'
A number of research projects are searching for more effective ways to match kidney donors and recipients.
Organisation of Clinical Research
King's Health Partners is the name of our Academic Health Sciences Centre and this includes King’s College London (KCL, the University), and the hospitals: Guy’s and St Thomas’ (GSTT), King’s College (KCH) and the Maudsley (SLAM).
The doctors and research teams are usually employed by either the university or the hospital but often actually work in both. Within KCL is the MRC Centre for Transplantation headed by Professor Sacks and within GSTT is the Biomedical Research Centre (BRC) headed by Professor Lord, both of which provide infrastructure and resources for kidney research.
As one of the biggest kidney and pancreas transplant centres in the UK, naturally quite a lot of our research energy is focused on this area but we are also very active in other areas of nephrology.
We have a fast growing clinical research programme in keeping with our aim to be at the forefront of treatment for kidney disease and transplantation. A selection of our current projects is listed below:
Nephrology and Dialysis:
- Dr Paramit Chowdhury is the local contact for a national study to assess whether high doses of intravenous iron can benefit haemodialysis patients (PIVOTAL).
- Dr James Pattison is looking at treatments that might minimise the need for steroid treatment in people with certain types of kidney disease (MinTac).
- Dr Joe Chilcot and Dr Joanna Hudson from the Institute of Psychiatry, Psychology and Neuroscience together with Dr Amy Carroll and Dr David Game in the renal unit are looking at the effect of psychological interventions on the wellbeing of dialysis patients (iDiD: improving distress in dialysis). This study has recently completed, with findings awaiting publication.
- Dr Game is also the principal investigator for the Rare Disease Register (RaDaR) at GSTT. This incorporates a database of rare and some not-so-rare kidney diseases which facilitates translational and epidemiological research into rare diseases through a comprehensive clinical database.
- Dr Michael Robson together with Dr Narayan Karunanithy in interventional radiology are leading a multi-centre study on how different radiology techniques can salvage dialysis fistulas that have narrowed (PAVE).
- Dr Robson is also is studying mechanisms of kidney injury in inflammatory kidney diseases.
- Dr Robson is also the local contact for a national study comparing different treatments for people with inflammatory kidney disease (PEXIVAS) and in Lupus (RITUXILUP)
- Professor David Goldsmith has various studies underway looking at how cardiovascular disease, bone disease and kidney disease interact.
- Linda Tarm, principal renal dietitian is looking at behaviour change and adherence to low phosphate diets in haemodialysis patients.
- Professor Tony Dorling is leading a study to identify patients whose kidney transplants may be at risk of failing, in order to optimize their medication and help their transplants last longer (OuTSMART). He has recently completed a study in ways to treat chronic rejection in transplant patients (RituxiCAN-C4).
- Dr Rachel Hilton, Professor Giovanna Lombardi and Dr David Game, assisted by Dr Maria Hernandez-Fuentes, are leading an international study to use cell therapy to protect newly transplanted patients from rejection (The ONE Study). The study is now closed to recruitment and the data are being analysed.
- Dr Hilton is the local investigator for a national study of quality of life and other outcome measures post-transplant (ATTOM). This study has now closed to recruitment and the data are being analysed. She has recently completed recruitment to two separate studies looking at new treatments to prevent CMV infection post-transplant.
- Mr Martin Drage, Professor Steve Sacks and Dr Richard Smith are looking at a new treatment for donated kidneys before transplantation in order to help them to work better and protect them from rejection (EMPIRIKAL).
- Professor Nizam Mamode, Mr Chris Callaghan and Professor Dorling, together with research registrar Mr Pankaj Chandak, are conducting a study using ex vivo normothermic perfusion (EVNP; perfusing organs at body temperature prior to transplantation) to precondition and therapeutically manipulate human kidneys to improve organ quality and enhance the number of transplant that we can perform. The group is also using 3D printing to derisk high risk transplantation.Professor Nizam Mamode is leading a multi-centre study to test a new treatment to reduce the need for steroids to prevent transplant rejection (ReMIND). He has recently completed a study on using a new drug to prevent rejection in highly sensitised transplant patients (Alexion studies).
- Professor Mamode, Mr Chris Callaghan and Mr Nikolaos Karydis are looking at assessing and improving unspecified kidney donation in the UK (the BOUnD study).
- Professor Steve Sacks and his team together with Dr Paramit Chowdhury are investigating a number of genetic biomarkers that can predict the chance of developing rejection. This study should also allow more precise tailoring of immunosuppressive drug doses following transplantation and reduce the risks of under or over immunosuppressing individual patients (KALIBRE). KALIBRE has completed recruitment and the data is now being analysed for publication.
- Dr Bob Vaughan, Dr Olivia Shaw and colleagues in the Clinical Transplantation Laboratory have a number of ongoing research projects looking at how to better match kidney donors and recipients as well as refining the detection of anti-donor antibodies in the blood of kidney transplant recipients.
- Professor Anthony Dorling has a long-standing interest in the role that antibodies play in transplant rejection and is looking at new ways to help understand when antibodies are harmful and when they may be helpful after transplantation. His group, along with Professor Mamode and Mr Nicos Kessaris, are about to begin a study of patients undergoing Antibody Incompatible Transplantation.
- Dr Maria Hernandez-Fuentes, who has recently left the research team to take up a new post, together with Dr Hilton are studying ways to detect whether patients have become tolerant to their transplant over time to see if we can successfully reduce immunosuppressive drugs in selected patients (GAMBIT). The results of this study are being analysed with the aim of developing a simple blood test that can predict whether or not a transplanted patient can reduce or even stop their immunosuppressive medication.
- Professor Graham Lord and his team are investigating the genes and proteins that are responsible for transplant rejection, heart disease and side-effects of immunosuppressive drugs in order to help design treatments to improve clinical care and survival of transplant patients.
- Professor Graham Lord and Dr. Paramit Chowdhury are the leads for the NIHR Health Informatics Collaborative at the NIHR GSTT Biomedical Research Centre (BRC). This programme was set up to bring together expertise from five of the country’s leading NIHR BRCs, along with their associated NHS trusts and academic partners, to make NHS clinical data more readily available to researchers, clinicians and industry. The NIHR Health Informatics Collaborative focuses on five scientific themes: viral hepatology, acute coronary syndromes, ovarian cancer, renal transplantation and critical care. Access to a population of more than 20 million people across the five centres provides an extensive resource for high-quality clinical data, electronic patient records for frontline delivery and continuity of care across different NHS trusts, and the ability to assemble large patient cohorts for cross-site translational clinical studies with academic and industry partners (www.nihr.ac.uk/about/hic.htm).
- Dr Antonia Cronin is conducting research into the ethics of kidney transplantation, with a particular interest in the use of kidneys from older deceased donors.
Links you might find interesting are listed below:
Updated October 2016