Results have been published today from a landmark piece of national research into what genes best predict the long term success of kidney transplants.
Every kidney transplant centre in the UK and Ireland contributed anonymised DNA samples via the UK and Ireland Renal Transplant Consortium and EU samples were also included in the analysis. It is a first in terms of the scale of the collaboration, and the kind of data it collected. The researchers used this wealth of data to narrow down the genes that predict long term kidney transplant success to a small section of DNA known as the HLA locus. The findings could help doctors personalise treatment and could reduce costs to the NHS as patients need less treatment or spend less time in hospital.
Knitting together data like this from across the UK is a huge undertaking, and shows what an important resource the NHS is for research. But this study had a local beginning here in the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.
The research originated in 2007, when the BRC at Guy’s and St Thomas and King’s College London was first establishing.
Professor Graham Lord, the then Deputy Director of the BRC, started a project to understand the best way to predict long term survival for kidney transplant patients. The research involved taking the entire genome of both a transplant patient and a kidney donor, then comparing the two, to understand what matches might help doctors choose the best donor-recipient pairing. Cellular methods were then used to understand how the genes worked in cells.
Professor Lord says, “We’re in a unique position here at the BRC. Guy’s and St Thomas has a great history of transplant medicine, and King’s College London is a centre for transplant research. When you bring that together with the genomic, immune monitoring, bioinformatics and other research platforms within our BRC, you’ve got a great opportunity to innovate.”
This first piece of research was funded by the Guy’s and St Thomas’ Charity, and focused on patients at the hospital. But the initial work was so successful, it grew into a national project, funded by the Wellcome Trust, which encompassed every renal transplant centre across the UK and Ireland, and using some EU samples. The number of partners involved were vital to give the researchers the amount of data required for genetics studies, and to ensure the results were applicable across a wide area.
The scale, however, also brought new issues, and so a number of other national bodies were involved. NHS Blood and Transplant handled the consent of the patients. They anonymised all the patient data from the Centres, before it was combined together for the research study. This meant that patient confidentiality was protected.
This was the first project made possible by the NIHR Health Informatics Collaboration, which aims to make NHS clinical data more readily available to researchers and the NHS community, for the purpose of improving patient outcomes.
It’s exciting that this ten-year project is coming to fruition. The findings could make a huge difference to patients in the future. But this isn’t the last of the project. As the paper notes, even this amount of data is relatively small for studies of this nature. So for more advances in medicine, more studies on the national and international scale are needed. Professor Lord notes:
“It took us ten years to collect this amount of data from across the UK and Ireland, but this is just the start. Collaborations like this one are going to become more common, and we’re going to have to adapt the way we think about research and data. It’s exciting, because the more we can use data on this scale, the more we can improve care for patients.”