A new grant from the Richmond-based Richard S. Reynolds Foundation to the VCU Health Hume-Lee Transplant Center will support research on increasing access to lifesaving transplants and improving organ transplant outcomes.

The $350,000 grant creates the Gupta-Levy Transplant Research Initiative, named for current Hume-Lee transplant physicians Gaurav Gupta, M.D., and Marlon Levy, M.D. 

The Reynolds Foundation carries the name of Richard S. Reynolds, the founder of Reynolds Metals, and was established by his wife, Julia Louise Reynolds, following his death in 1955. It has awarded more than $60 million in funding to a range of causes, from art and the environment to science, education and health care.

Three projects and a “seed fund” get the green light

The Reynolds Foundation grant will support three research projects led by Hume-Lee. It will also develop a “seed fund” to support young researchers and pilot projects in kidney transplant research.

“We are grateful to the Richard S. Reynolds Foundation's ongoing commitment to scientific research that improves the health of many,” said Levy, director of the Hume-Lee Transplant Center. “Their investments have been critical to the success of projects at the transplant center and across VCU to save and improve lives in the communities we serve.”

The Reynolds Foundation has a demonstrated track record of supporting research across a number of medical specialties at academic medical centers, including at VCU Health.

“Those of us associated with the foundation are aware of the life-altering and life-saving work of the Hume-Lee Transplant Center,” said the foundation’s president, Richard S. “Major” Reynolds III, grandson of the family’s patriarch and brother of the late Virginia Lt. Gov. J. Sargeant Reynolds. “Through the national reputation of programs on the MCV Campus as well as through personal experience of family and friends, we are familiar with the quality of the treatment provided. Aiding in the expansion of their work through research is exactly the kind of thing our foundation likes to do.”

Changing the organ evaluation process

Across the United States, about 10 donated kidneys are discarded each day, while 12 people die every day waiting for a transplant, according to the National Kidney Foundation. With a need so great, every organ counts.

In collaboration with the United Network for Organ Sharing (UNOS), the Reynolds Foundation grant will support Hume-Lee research on ways to improve the evaluation of donor kidneys so fewer organs go unused.

Researchers want to move beyond the standard Kidney Donor Profile Index (KDPI), which centers often use to evaluate a kidney. The team would like to explore additional methods to assess the kidney function in the donor. The approach uses such tools as biopsies, kidney pump tests and microscopic evaluations.

The researchers want to learn whether combining these tests will improve the assessment of donor kidneys and lead to better predictions of which patients will have better outcomes with organs that often go unused.

The findings may shed light on whether kidneys estimated to have shorter lifespans based on the KDPI, which are typically discarded, might still benefit someone on the national waiting list. The list currently stands at more than 100,000 people. What’s more, financial support provided by the Richard S. Reynolds Foundation will help the team implement their findings.

Hume-Lee hopes the study will support updating the KDPI to include the study data, thereby reducing the number of donor kidneys discarded.

Over the past several years, Hume-Lee and UNOS have developed a successful partnership for conducting transplant research. This initiative will build upon previous research collaborations.

“Every transplant is a life changed,” said Gupta, who is medical director of kidney transplantation at Hume-Lee. “Any way we can take a closer look at a viable kidney to match the right organ with the right recipient, we’re going to do it.”

Customizing anti-rejection drugs to each patient

After a kidney transplant, patients generally take anti-rejection medication their entire lives. At most transplant centers, patients receive similar levels of immunosuppressant medication regardless of their age or risk of rejection. These powerful medications have both lifesaving benefits and side effects.

But what if there was a specialized blood test to determine just how much immunosuppressant medication a recipient should get?

In partnership with the VCU Lipidomics/Metabolomics Core (VLMC) laboratory, Hume-Lee is investigating a blood test that may show which patients are more prone to rejection than others. Using this test to tailor drug dosage to the individual risk of rejection would have numerous positive effects on patients. 

The Reynolds grant will allow researchers to expand this research to develop a large, detailed biobank to confirm initial findings. Besides reducing the severity of medication side effects, the work could ultimately help reduce rejection, infection and cancers in recipients.

Determining kidney success before transplantation

Monitoring kidney function after transplant is important. Hume-Lee, through its collaboration with the Alberta Transplant Institute at the University of Alberta, Canada, has determined that gene expression-based molecular assessment is a new and improved way of examining kidney biopsies post-transplant.

Because kidney biopsies aren’t standardized, evaluation of the organ is subject to interpretation — including bias on the part of the pathologist assessing it. Hume-Lee researchers believe work is urgently needed to minimize bias, especially when a donor kidney is being evaluated for transplant. Improving this process is important in light of the nation’s dramatic organ shortage.

Prior research on post-transplant kidneys using the assessment has proven that gene expression-based molecular assessment is an effective way to assess kidney function. 

Now, the team aims to take its research to the next level by using this innovative means of assessment to evaluate deceased donor kidneys before they’re transplanted. Is this a successful way to limit bias and better predict the function of the organ after transplant? The team intends to find out.

Hepatitis C positive kidneys into hepatitis C negative recipients

Transplant research at Hume-Lee is the foundation for treatment advances that have increased access to organs. Recently, Hume-Lee implemented a unique process that allows the safe and effective transplantation of hepatitis C-positive kidneys into recipients who don’t have the infection, thereby expanding the pool of available donor organs.

To share the results with other transplant centers across the country, the Hume-Lee research was recently published in the American Journal of Transplantation.

The process requires patients to receive oral anti-viral medication prior to the transplant to prevent the transmission of hepatitis C from the donor organ to the recipient. Study results showed that after successful treatment, the risk of transmission is extremely low. If infection were to occur, the transplant team could easily treat it.

Since the yearlong trial in 2018, Hume-Lee has successfully transplanted more than 150 hepatitis-C positive kidneys into hepatitis-C negative patients.

Seed funding

The $350,000 Reynolds grant, paid over four years, includes a $250,000 challenge grant to encourage other donors to support transplant research. While the initial $100,000 is directed at expansion of the three current projects, future funds will help VCU grow its kidney transplant studies with aspiring researchers.

“There are many, many other projects we are doing that could really change the landscape for kidney transplantation — not only in Virginia, but around the world,” Gupta said.

You can support kidney transplant research at VCU Health

If you or your loved ones have been impacted by a kidney transplant or have interest in furthering transplant treatment and research, please contact Niles Eggleston, assistant vice president for development, at (804) 828-2112 or niles.eggleston@vcuhealth.org.

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