Search Results for: transplantation

Thinking outside the ice box: revolutionising pancreas transplantation

Karim Hamaoui provides an insight into an innovative solution for the organ donation shortage – a technique that allows the pancreas to be preserved for longer and for better function.

The pancreas responsible for producing one of the body’s most important hormones: insulin. Since the first pancreas transplant in 1966, this procedure has revolutionised the treatment of type 1 diabetes. To date, pancreas transplantation is the only definitive treatment to render patients free from daily insulin injections and provide a better quality of life for these patients.

A key problem in the UK and worldwide is the limited supply of organs available and suitable for transplantation. The majority of pancreases used for transplantation in the UK come from a person who has died, and whose relatives have given permission for them to become an organ donor. To meet demand, the criteria used to identify suitable donors can be expanded from ‘ideal’ to ‘extended’ criteria. Extended criteria donors can also be euphemistically referred to as donors with ‘medical complexities’. They are normally aged 60 years or older, or aged over 50 years but with at least two of the following conditions: high blood pressure history, degree of kidney impairment, cause of death from a stroke. Unfortunately, complications are more pronounced for these types of organs. (more…)

Going with our guts to find new treatments: faecal microbiota transplantation at Imperial

Dr Ben Mullish and Dr Julie McDonald explore the ins and outs of faecal microbiota transplants – it may sound unpleasant but this procedure is proving to be an effective way of treating chronic gut infections.

Most of us can name (or may have had first-hand experience of) a number of different bacteria that can cause serious gut infections, such as Salmonella or Campylobacter.  However, what is less well-known is that we also have billions of bacteria living in our guts that normally do us no harm at all.  Some actually have important contributions towards our health – including prevention of bacterial pathogens entering our gut and causing infections.  Collectively, this huge population of microorganisms living inside our digestive tracts is often referred to as the ‘gut microbiota’.  If anything happens to us that disturbs or kills off members of this gut microbiota – such as exposure to antibiotics, or surgery – then we have greater vulnerability to gut infections, and particularly from a form of bacteria called Clostridium difficile. (more…)

Advancing liver health through microbiome research

Dr Benjamin Mullish

On World Liver Day, Dr Benjamin Mullish from the Department of Metabolism, Digestion and Reproduction, discusses the research being done on the microbiome and faecal (or ‘intestinal’) microbiome transplants (FMT), and how he hopes that can be converted from ‘bench to bedside’ to improve the lives of patients with liver conditions. 

When most of us hear the words ‘gut bacteria’, we think about germs that can cause infection and make people ill.  However, more recently, scientists and doctors have recognised that we also have billions of ‘beneficial’ bacteria (and other microbes) in our gut that play important roles in keeping us healthy.   The specific ‘mix’ of microbes that a person has in their gut, and the environment in which they live – now often called the gut microbiome – is distinct between different people like a fingerprint.  Furthermore, the gut microbiome is influenced by and altered by a number of factors, including our diet, our medications (particularly antibiotics), and how old we are.

Of further interest, we now think that our gut microbiome plays an influence over our vulnerability to developing a range of medical conditions, how the condition progresses if we do develop it, and even how well we might respond to different treatments used for the condition.  This includes a number of different liver diseases; the gut and the liver are very close physically within the body, and the gut microbiome seems to be an important factor that impacts upon how these two organs ‘talk to’ each other in health and disease.  Within the Section of Hepatology and Gastroenterology, one of our major areas of research relates to how an altered gut microbiome may contribute to different liver diseases, and whether we might be able to alter the gut microbiome as a new approach to treating them.

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World AIDS Day: We have come a very long way but there is still much to do to protect those at risk

Professor Sarah Fidler

This festive period Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.

While HIV is no longer the death sentence that it once was, lifelong treatment is still required and there is no cure – yet. Professor Sarah Fidler from the Department of Infectious Disease discusses how a new type of HIV treatment holds promise as a longer-lasting alternative to current complex drug regimens.

Despite extraordinary political and medical advances, HIV, the virus that causes AIDS, remains one of the world’s most serious public health challenges. Since its discovery in 1983 by researchers at the Pasteur Institute in France, 84 million people worldwide are estimated to have become HIV-positive and 40 million people have died from an HIV-related illness. Today, there are around 38 million people living with HIV globally, with 1.5 million new infections in 2021.

Advocacy and close collaboration between clinicians, scientists and the HIV-affected community has inspired and driven the research and drug development and access agenda. Without these close working relationships, the development of HIV treatments would have been markedly slower and many more lives would have been lost.

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News worth celebrating for the cystic fibrosis community

Professor Jane Davies reflects on the positive news for those affected by cystic fibrosis on both sides of the Atlantic – access to Orkambi on the NHS and FDA Approval of ‘triple combination’ in the US.

Last week marked a milestone for people living with cystic fibrosis (CF) in the UK after NHS England announced that new drugs – Orkambi and Symkevi – will be made available on the NHS after securing a deal with the drug manufacturers, Vertex. After four years of community and patient organisation campaigns, I am delighted with this outcome which will be transformative for young people with CF.

There are over 10,000 people in the UK and over 100,000 worldwide estimated to be living with cystic fibrosis (CF). The condition is caused by a faulty gene encoding for a cell surface ion channel called Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Ion channels are integral for regulating salt and water transport across mucosal surfaces, particularly in the lungs for defence against infections and in the digestive system. People with CF have a shorter life expectancy than healthy people and a hugely burdensome treatment regime just to keep as well as possible. (more…)

There’s a whole world inside of you: a guide to microbiome research

Kate Gallagher provides an insight into microbiome research; a promising area of science that may pave the way for new treatments for a number of conditions ranging from inflammatory bowel disease to cancer.

You may be familiar with the age-old phrase, ‘you are what you eat’. Whilst I can assure readers that despite ingesting an inordinate amount of Reese’s pieces, you probably aren’t nuts, recent developments in research into the gut microbiome are beginning to tell us that the population of microbes inhabiting our gut may be much more powerful than we’ve previously given them credit for.

What is the microbiome?

The term microbiome refers to the additional set of genes arising from the diverse and unique array of microbes that have established themselves in a variety of habitats throughout our body. This is not to be confused with the term microbiota, simply referring to their names and quantities. These communities of bacteria, viruses, fungi and yeasts can be found in significant proportions in regions such as the gastrointestinal and reproductive tracts, your oral cavity, and skin. Overall, bacterial cells in our body match the number of human cells at a 1:1 ratio, meaning the microbiome has a significant contribution towards our genetic diversity, harnessing great potential to aid our understanding of a number of medical conditions targeted by decades of research. (more…)

Is mycoprotein an ideal food for managing blood sugar levels in Type 2 Diabetes?

For Diabetes Awareness Week, Anna Cherta-Murillo explains how mycoprotein, a food made of fungus, may hold the promise for managing blood sugar levels in Type 2 Diabetes.

If I were to ask you the first thing that comes to mind when you think of fungi, you would probably say mouldy walls, gone-off food, or athlete’s foot. The Fungi kingdom is often not viewed in a positive light. However, we owe a lot to fungi; they produce life-saving antibiotics, have allowed organ transplantations in humans and can recycle many types of waste. In the area of nutrition, some fungi also have the potential to affect human health in a beneficial way, although little research has been devoted to it compared to other foods. In the Nutrition Section of the Department of Medicine at Imperial, we are putting fungi into the limelight and studying the impact of a particular type of fungus on blood sugar levels and appetite in South Asian and European people with Type 2 Diabetes (T2D).

The problem

1 out of 20 people worldwide has T2D, with South Asians being more prone to the disease compared to Europeans (Figure 1). People with T2D have higher blood sugar levels than normal, which over time can increase the chances of developing long-term complications such as blindness, kidney disease and heart failure. It is therefore important to manage blood sugar levels in people with T2D in order to keep blood sugar in the normal range. The first-line strategy to achieve this is by improving dietary intake. Healthy, balanced diets are generally characterised as being high in dietary fibre and protein, which decrease both blood sugar levels and appetite. If blood sugar levels are reduced toward normal levels, the chances of having T2D-related complications are reduced. Likewise, if appetite is decreased, intake of energy-rich foods will likely also decrease, helping to reduce body weight, which is a key risk factor for T2D. However, an ongoing problem with healthy diets is that they are not suitable for all cultures and most of the research around them has been conducted in people of European origin, therefore not being applicable to South Asians. Furthermore, people often find it difficult to stick to these diets. (more…)

Building a heart, one cell at a time

Dr Michela Noseda took cardiac cells to the stage at her recent TEDx talk on how scientific approaches she uses can help us understand how to beat one of the biggest killers of our time – heart attacks.

Heart attack (myocardial infarction) remains the foremost killer worldwide. The prevalence remains high despite the fact that we have been reducing risk factors; stopping smoking, eating a healthy diet and exercising. In fact, the persistence of myocardial infarction as the most frequent cause of death is related to an ageing population and the move of people towards big cities. (more…)

Change of heart: will advanced therapeutics replace heart transplants?

To mark the 50th anniversary of the first UK heart transplant, Professor Sian Harding looks at the future of transplantation in this post. 

Fifty years ago, history was made at the National Heart Hospital in London with the first heart transplant performed in the UK. Half a century later, transplantation continues to the be the gold standard treatment for a failing heart. However, the growing number of people on the waiting list for a new heart, coupled with the risky and complex nature of the procedure is resulting in scientists exploring alternatives to transplantation. One of these alternatives is gene therapy. (more…)

Would you give the gift of a kidney to a stranger in need?

Kidney donations stranger

It is the season of giving, so we look at how kidney donations from strangers are giving kidney disease patients a second chance at life. 

As far as generous Christmas presents go, donating your kidney seems for many at the extreme end. However, for a few lucky kidney disease patients, this is the gift of a lifetime. Known as unspecified or non-directed altruistic kidney donation, this form of live organ donation is on the rise, and could potentially wipe the waiting list if more stepped forward. I met Frank Dor, a consultant transplant surgeon and Head of Transplantation at Imperial College Healthcare NHS Trust, who has carried out hundreds of live organ donations. (more…)