To find out about some of the research going on at Guy’s and St Thomas’, our intern Jasmine Ebanks has interviewed some of our researchers about their work and their career path into research.

She spoke to BRC researcher, Dr Paramit Chowdhury.

During his training in renal medicine, Dr Paramit Chowdhury undertook a PhD at King’s College London, which sparked his interest in research. Dr Chowdhury has a busy clinical schedule as a consultant nephrologist, but remains involved in non-commercial and commercial clinical treatment studies and is the R and D Lead for the Transplant, Renal and Urology clinical directorate.

Organ transplantation interested him while training and remains an area of interest. He was puzzled to find that great technology was available to transplant organs but less was available to determine how a transplanted organ was doing and make it last as long as possible.

For example, identifying when an organ is being rejected is usually done through a biopsy. This only detects rejection once it’s established and the damage has been done. Ideally, by looking for cetian biomarkers in blood and urine, they might be able to detect the processes of rejection weeks before it occurred.

As a chief investigator of biomarker studies, Dr Chowdhury’s goal is to identify and diagnose rejection non-invasively by testing transplant patients’ blood and urine samples and maybe avoiding the need for a biopsy.

In a previous study including about 250 patients, Dr Chowdhury was part of a team which collected and analysed blood and urine samples regularly throughout their first year post transplant. They were able to identify a gene signature that might have been able to identify kidneys which were being rejected.

‘’It also looked like that signature was positive up to two months before the actual rejection happened.’’

Dr Chowdhury says these techniques could help clinicians personalise the anti-rejection treatment they give to transplant patients.

”We tend to give everybody the same thing. It’s a bit like if you’re walking into a shop to buy a shirt and there is only one size. What we do is you have to buy the shirt, wear it and then keep bringing it back for alterations. It would be much better if we were able to give you a shirt that was the closest fit and that’s what the research I’m involved with can hopefully deliver.”

One of the biggest challenges in organ transplantation is the side effects of suppressing the immune system to ensure patients’ bodies’ don’t reject the organ. These side effects can include infection, cancer, diabetes and high blood pressure. The ability to personalise anti-rejection medication could help reduce these.

Another area of interest in the department is the complement system of the immune system. This can damage the transplant kidney through something called ‘ischaemia-reperfusion injury’ which is unavoidable during the transplant operation. The EMPIRIKAL study involves treating the kidney outside of the body, after removing it from the donor, with complement inhibitor. When patients are treated with complement inhibitor for other conditions, their entire body is affected by complement inhibition increasing the risk of infection. By treating the organ ex vivo, the goal is to limit the side effects of suppressing the immune system.

When I asked Dr Chowdhury what advice he would give to someone who’s interested in pursuing research he said:

‘’I think the potential for changing practice and doing good is huge and that’s what drives me. You know that if you can make one contribution to improving patient care, it’d be fantastic. As a full-time clinician you struggle for time, but it gives you a clinical outlook that is important to understand. … It’s not going to happen overnight so you’ve got to be persistent as well. You’ve got to be able to take knockbacks.’’

In addition to this research and clinical work, Dr Chowdhury is a part of the NIHR Health Informatics Collaborative, a partnership between NHS Trusts and Health Boards aiming to facilitate the re-use of NHS clinical data for translational research .