Transplantation Surgery

Operation med tre operatörer i operationskläder

Kidney transplantations have been done in Uppsala since 1969. Photo: Bengt von Zur-Mühlen

Transplantation research is based on clinical need but encompasses both clinical and experimental research.

Most of the research is done in a collaborative fashion within the University in particular with the department of Clinical Immunology, but also Pathology, Nephrology, Anaesthesiology, Neurosurgery and Radiology are involved.Although the topics can be listed as separate items these may in several aspects be interrelated either by technology or goal. Under the broad heading transplantation immunology we conduct clinical research on tolerance and the generation of regulatory T-cells to reduce/abolish the use of immunsuppression. Also research is directed to overcome the AB0-barrier as well as anti-HLA antibody barriers. The latter is dependent on the use of complement inactivation and/or IgG-degradation.More specifically ischemia re-perfusion is studied in a large animal model in renal, pancreatic and islet transplants. Furthermore studies are in progress to explore the possibilities of blockade of apoptosis.

Outside of the heading of regenerative medicine patient management and live donor management are important areas for both technical and psychological development. Thus, we have research/developmental programmes for clinical islet transplantation, live donor kidney donation, clinical pancreastransplantation and management of malignancies after transplantation.

The second topic may be assembled under the broad heading of regenerative medicine. The common denominator is the knowledge that organs transplanted are damaged all the way through the procedure until after re-perfusion. The following damaging events have been identified: brain death, harvesting procedure, storage with ischemia and finally re-perfusion injuries. It is also recognised that all these factors together generate rather non-specific damages, which may switch the organs from a neutral to a pro-inflammatory state. Further, it is recognised that especially the storage period with cold storage or machine perfusion, warm or cold, may offer an opportunity of repair by endothelial or perfusion solution modulation to improve the long-term transplant outcome.

The field of transplantation research is very heterogeneous but it has a common focus of clinical need.

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