What we do:

Focus on Ending Transplant Failure


The Challenge

Transplanted organs do not last forever.  This is a major problem today.  Currently, patients that wait months to years for an organ transplant, When they finally receive one, they are only getting a temporary fix.  Rarely, transplant function can last for over 25 years. On average kidney, heart, liver, and pancreas transplants last 10-15 years. Lung and intestinal (multivicseral) transplants have a much shorter average life.  They maintain adequate function for about 5 years on average.  Over the last 50 years, transplant researchers and clinicians have made remarkable progress in preventing transplants failure in the first year post-transplant. However, poor long-term (beyond the first-post transplant year) survival of a transplanted organ (allograft) remains the major problem in transplant care today.

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The Opportunity

Historical reports on the causes of allograft failure have pointed to a plethora of contributing issues. However, in recent years, alloantibody-mediated injury has emerged as the major cause of allograft loss. Alloantibodies and the alloimmune response have always been a cause of allograft failure. Early failure and hyperacute rejection were a direct result of the alloimmune response. Fortunately, the use of crossmatch techniques and avoiding crossmatch positive transplants has largely eliminated early alloimmune rejections. However, it is also now clear that patients can develop antibody-mediated injury in the first year post-transplant and beyond.

Circulating antibodies directed toward donor human leukocyte antigens (HLA) (donor-specific anti-HLA antibodies, DSA) are now thought to be the major cause of allograft loss. Although, we know more about these antibodies and their ability to injure the transplanted organ than we did even a decade ago, we still have much to learn.

We must develop a stronger understanding of immune injury in transplant and develop new diagnostic and therapeutic tools to make a patient's first organ transplant last forever.


Our Strategy

We must develop a stronger understanding of antibody mediated injury in transplant and develop new diagnostic and therapeutic tools to eradicate this problem in transplant. Here at the Terasaki Research Institute, we are working to make this happen. Our scientists will work to develop a stronger understanding of antibody mediated injury in transplant and develop new diagnostic and therapeutic tools to eradicate this problem in transplant. We will do work in three key research areas: epidemiological research, novel diagnostic/biomarker development, new prevention and therapeutic strategies.



Through our many collaborations, including our largest - Multicenter Transplant Alliance consortium, we will gather data and use this data to discover a new clarity of allograft rejection and failure.  Bringing a very large number of patients and an even larger number of data points into one system, we will be able to use big data science to model, learn, and advance the innovation and discovery process in transplantation. 


We will develop new or improved diagnostic tools using advanced technology. We will begin with developing new testing technologies to better understand the problem of antibodies.  In addition, we will be conducting translational research to develop tests that can indicate allograft injury or immune activation.  Finally, we are focused on developing companion diagnostic tools that can better guide therapies used to eradicate or halt alloantibody mediated injury.


And finally, at the Terasaki Research Institute, we will be actively developing new ways to treat and prevent rejection in transplant. Our research and development team is working to develop new therapeutic medications, approaches, and regimens that can solve the problem of chronic rejection. In addition, through the Multicenter Transplant Alliance consortiums (MTA-K, MTA-P, and MTA-L) we will work to bring these and other new therapies to transplant faster.

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