The NIHR Leeds In-Vitro Diagnostics Co-operative is a partnership between Leeds Teaching Hospitals NHS Trust and the University of Leeds. We therefore have access to a wide range of clinicians, scientists and academics, who become an extension of our team when it comes to working on the specific feasibility and assessment projects that we deliver.
Here we catch up with Mark Lobb a Clinical Scientist from St James’ University Hospital who is planning to work in collaboration with our Associate Clinical Director and Renal Theme Lead, Dr Lewington on an upcoming feasibility study into kidney health, post-transplant.
Mark, tell us about your role……
I am currently a Clinical Scientist in the Transplant Immunology Lab at Leeds Teaching Hospitals where I’ve worked in various roles and guises for nearly 10 years. Day to day I am responsible for running the histocompatibility section of the laboratory, where in simple terms our job is to assure and assess compatibility between potential transplant recipients and donors.
As part of my role and development I’m currently also on a national training scheme called Higher Specialist Scientific Training (HSST) and as part of this scheme I will undertake a doctoral research project. This is where my work with NIHR Leeds In-Vitro Diagnostic Co-operative comes in. Alongside my day job I will be working on this new feasibility and observational study into a novel non-invasive diagnostic approach to assessing kidney transplant health, called The Transplant Related Immunity and Diagnostic DNA Study (TRIADD).
How did you get involved in working with NIHR Leeds MIC?
I was introduced to Dr Lewington via the Consultant Clinical Scientist for my laboratory, Brendan Clark, who has worked with Dr Lewington for a number of years and together, along with Consultant Immunologist Dr Savic, developed the idea of TRIADD. I am now part of the TRIADD project team and will be responsible for putting the protocol together as well as delivering the ‘science’ which includes all associated laboratory work. Funding for my work and the project is by way of a grant from Leeds Hospitals Charity.
What is the TRIADD Study?
Currently the tools and laboratory tests that we use to assess and monitor the performance of a kidney post-transplant are relatively limited, which can make post-transplant management challenging. There are certain tests that have been around for a long time and the ‘Gold Standard’ way of understanding what is going on inside the kidney is the biopsy, which can be invasive and uncomfortable for the patient.
The TRIADD study is essentially about finding a better way of monitoring the health of a transplanted kidney and ultimately better predicting donor kidney rejection, facilitating earlier clinical intervention.
What will the study involve?
By measuring the levels of two novel biomarkers in patients post-transplant, we will be able to accurately monitor the health of the transplanted kidney. This will involve us recruiting a cohort of kidney transplant patients to be part of the research study. In total around one hundred patients will be recruited.
Aligning with routine care, the TRIADD study will collect blood and/or urine samples from these study participants. At the point of acute kidney injury, cfDNA is released from the donor organ, into the patient’s blood. By monitoring the levels of cfDNA, it is hoped that kidney injury can be identified at an earlier stage.
The hope is that the tests that we are going to do and validate will be much more specific and accurate than currently available, meaning that if we think something is going on with the kidney post-transplant, we can do a biopsy sooner or we can avoid biopsies all together. The result being a much more efficient and targeted use of this procedure with resultant cost savings to the NHS.
When will you complete the study?
Following approval from the ethics board, the patient research will be undertaken over a 12-month period followed by a six-month period of testing, analysis and reporting which will take us to the start of 2024.
What will the patient benefits of the study be?
The ultimate aim of the study is to understand whether these tests will enable us to provide a better level of care to patients. Cell free DNA testing has been successfully used in other areas of medicine such as Oncology, but the element of the testing which will aim to identify whether kidney injury has occurred and what has caused it, without the need for biopsy, is a completely new way of establishing the cause of kidney injury. In time this DNA based approach could completely replace current testing practices providing earlier intervention/diagnosis for patients.
To find out more about the projects our team delivers – contact us HERE.