NIH Grants $10M to Study Immune Cells’ Role in Lung, Heart Transplant Rejection

Research investigating the role of immune cells in triggering lung and heart rejection following transplant will be supported by $10 million in grants from the National Institutes of Health (NIH).

The grants, awarded to scientists at Washington University School of Medicine in St. Louis, will support research that aims to enhance the viability of hearts and lungs following transplant surgery, and boost patient survival.

Lung transplants are the only curative treatment for people with end-stage lung disease due to conditions such as pulmonary fibrosis and cystic fibrosis.

An award of $7.7 million from the National Institute of Allergy and Infectious Diseases, part of the NIH, will fund research into the immunological response underlying lung transplant rejection. Related research into the mechanisms leading to heart transplant rejection was granted nearly $2.6 million from the National Heart, Lung, and Blood Institute, also part of the NIH.

“The ultimate goal is to improve the long-term outlook for lung and heart transplant patients,” Daniel Kreisel, MD, PhD, surgical director of lung transplantation at the School of Medicine and Barnes-Jewish Hospital, principal investigator on both grants, said in a press release.

“Understanding how immune cells respond to transplanted organs sets the stage for developing novel therapeutic strategies to improve outcomes for transplant patients,” Kreisel said. “It is our hope that through our research, we will gain critical new insight into the immunological underpinnings of transplant tolerance and rejection.”

The risk for organ failure is particularly high in lung transplants. According to the U.S. Organ Procurement and Transplantation Network, known as OPTN, only 50% of transplanted lungs are still functioning in the five years post-surgery — much lower than the 70% organ survival rates seen in heart, liver, and kidney transplants in the same period.

Unlike other organs, lungs are in contact with the “outside world,” being exposed to the air and all its contents, such as bacteria, viruses, and pollution. This increases the risk of rejection and organ failure.

“Uncovering the basis for the poor survival of lung transplant recipients should also give us new insight into the causes of other inflammatory diseases that affect the lung,” said Andrew Gelman, PhD, a professor of surgery, and of immunology and pathology, at Washington University.

The funding will support three projects tackling the role of the recipient’s immune system’s response to lung transplant. The projects are led by Kreisel, Gelman, and Alexander S. Krupnick, MD, director of the lung transplant program at the University of Maryland.

Wenjun Li, MD, an associate professor of surgery and director of microsurgery in the thoracic immunobiology laboratory at Washington University, also will play a key role in the project. Li is known for having developed microsurgical and imaging methods to advance lung and heart transplants.

Kory J. Lavine, MD, PhD, a Washington University associate professor of medicine in the cardiovascular division, is one of the leading researchers on the project. He is investigating the role of the immune system in heart transplant rejection.

According to OPTN, more than 3,500 people received a heart transplant from a deceased donor in the U.S. in 2019.