Transplantation is a life-saving therapy for patients with end-stage organ failure. The University Medical Center Groningen (UMCG) is the most prominent transplant centre in the Netherlands and is the only centre licensed to perform all types of solid organ transplantation.

Transplantation is a multidisciplinary treatment, in which various specialists closely collaborate. Organ-specific knowledge, both physiological and anatomical, is essential to ensure optimal outcomes.

The GIOT programme integrates experience and knowledge to better understand the chain of events during transplantation and to improve the translation of basic research results to clinical practice.

Relevance

Improving long-term quality of life

Organ transplantation has an enormous impact on patients by improving their quality of life and life expectancy. Patients and grafts go through different ageing processes. For instance, some recipients have a donor organ that is much older than they are. Therefore, individual strategies are needed in terms of immunosuppressive drugs, nutrition, and lifestyle advice.

The chain of events in the transplantation process can lead to various multicausal injuries that may accelerate the ageing process of the donor organ. By providing more insight into the organ donation chain, the GIOT programme intends to:

  • Improve the management of the donor and optimize the donor organ quality;
  • Preserve the organ;
  • Reduce early organ damage following implantation, e.g. caused by ischaemia-reperfusion injury;
  • Reduce chronic graft dysfunction;
  • Improve long-term quality of life.
  • The increased need for transplantable organs forces transplant professionals to accept organs from suboptimal donors, the so-called extended criteria donors (ECDs). Preserving or even improving organ quality during the predonation phase by evidence-based donor management, donor preconditioning, and optimization of retrieval techniques is essential to organ transplantation.

    The GIOT research will improve outcomes of transplantations involving organs from suboptimal donors and promote wider use of such organs.

  • Although the current accepted standard is static cold storage, more sophisticated techniques such as cold and normothermic machine preservation are necessary to improve the functional quality of ECD organs. Normothermic machine preservation is beneficial in terms of allowing functional testing and pharmacological conditioning of the organ.

    The UMCG is a world leading institute for the development of methods for heart, lung, liver, kidney, and small bowel preservation.

  • The GIOT researchers examine and develop novel strategies to decrease injurious processes and to improve repair processes. Graft reperfusion is a critical part of the chain of events during transplantation. Reperfusion injury may negatively affect organ quality and function, additional to any pre-existing injuries, especially in ECD organs.

  • Even after a successful transplantation, there is no guarantee of good long-term function. Various processes may affect organ function and survival, including graft rejection, recurrent disease, and graft fibrosis, leading to decline in function. In addition, recipients may experience side-effects of immunosuppression until well after transplantation. Research on these topics will improve long-term graft and patient survival and, therefore, patients’ quality of life.