NIH Gives $12.9 Million to Establish First Lung Transplant Network Among Hospitals

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Grant is first of its kind funded solely for the purpose of studying lung transplantation.

Dr. Scott Palmer

“The funding and support will allow us to answer important questions that could translate directly into improved patient care and better long-term outcomes for our lung transplant patients.” - Dr. Scott Palmer

The National Institute of Allergy and Infectious Diseases, a division of the National Institutes of Health, has awarded a $12.95 million grant to a Duke University School of Medicine researcher to create a national Lung Transplant Clinical Trials Network, the first collaboration funded solely for the purpose of studying lung transplantation.

Dr. Scott Palmer, Associate Professor of Medicine and Vice Chair of Research for the Department of Medicine at Duke University Medical Center, and his colleagues have assembled a network of investigators at five academic lung transplant centers: Duke, the Cleveland Clinic, Johns Hopkins University, the University of California-Los Angeles, and the University of Toronto. Palmer, director of pulmonary research at the Duke Clinical Research Institute, will serve as principal investigator for the entire network.

The new network will be part of the Clinical Trials in Organ Transplantation program (CTOT), an investigative consortium for conducting clinical studies that will lead to improved outcomes for lung transplant recipients. Lung transplant patients have the worst survival rate among commonly transplanted organ recipients. Most of the drugs that are prescribed for lung transplant patients were developed to treat other conditions. Since its inception, CTOT has primarily funded studies of heart, kidney, or liver transplants.

“The fact that we were funded to put together CTOT’s first lung network is pretty unique,” Palmer said. “It speaks to our strengths in clinical research, transplant immunology, and the success of Duke’s clinical lung transplant program. It also reflects a growing recognition of the importance of lung transplantation as an effective treatment for patients with advanced respiratory disease.”

Improving the lives of lung transplant patients is at the heart of the Lung Transplant Foundation’s mission. The Foundation supported earlier research by Dr. Palmer relevant to the goals of the CTOT grant. President Jeff Goldstein said the multi-center collaborative project will create opportunities that, in the long run, will benefit patients.

“When it comes to raising money for research, there is often a lack of a cooperative effort,” he said. “The more centers you have involved, the more distinguished doctors you have moving the research forward, the greater the opportunity for outcomes that will result in ways to improve the lives of lung transplant recipients.”

Lung transplant recipients are the fastest-growing segment of organ transplant patients. This growth is expected to continue due to increasing rates of advanced lung disease as well as increasing lung donor utilization rates. However, this increase in transplant rates has not been accompanied by an improvement in patient outcomes. The median long-term survival rate for lung transplant patients is six years.

Part of that is due to chronic lung allograft dysfunction (CLAD), a condition in which the body “rejects” the lungs. When a lung is transplanted into a patient, his body will naturally attack and try to “reject” the transplanted organ because it perceives it as a foreign body. Transplant recipients must take immunosuppressive – or “anti-rejection” – drugs for the rest of their lives. But, for reasons unknown, sometimes the body still rejects the lungs, causing the patient’s lung function to drop, shortness of breath, and, eventually, death.

“Before this NIAID grant for the lung transplant clinical trial network, serious government support on a large scale basis has been sorely lacking,” Goldstein said. “The Lung Transplant Foundation’s mission is to support this kind of translational research.”

As a recipient of a double lung transplant himself, Goldstein is particularly encouraged that the scientific community will now focus directly on improving the lives of lung transplant patients through this unique collaborative research effort.

“My transplant was 11 years ago," Goldstein said. “Every year is precious. Time that passes without a significant breakthrough in research is time that I and other patients don’t have to spare. Collaborations like this one give us all hope.”

In the LT-CTN, Palmer and his team will address important post-transplant complications that contribute to relatively poor long-term outcomes. First, through a randomized clinical trial that incorporates a novel immune assay, investigators will test an approach to reduce cytomegalovirus (CMV) infection, which often afflicts transplant patients and contributes to early graft failure. Second, through a prospective multicenter registry that includes extensive biobanking of clinical samples, investigators will seek to better understand the phenotypes and mechanisms of CLAD, a major cause of death after lung transplantation. In addition to the four clinical programs at the other transplant centers, the network includes a clinical CMV immune monitoring laboratory, two mechanistic CMV laboratories, and one CLAD mechanistic laboratory.

Palmer noted that a key strength of the LT-CTN is the broad expertise of the entire team, which includes specialists in medicine, surgery, pulmonary research, transplant infectious disease, immunology, biostatistics, and bioinformatics.

“This project provides us with an opportunity to move the field of lung transplant studies forward,” Palmer said. “The funding and support will allow us to answer important questions that could translate directly into improved patient care and better long-term outcomes for our lung transplant patients.”

To interview Jeff Goldstein, president of the Lung Transplant Foundation, call 305-401-1001 or email jeff(at)lungtransplantfoundation(dot)org. To interview Dr. Scott Palmer, contact Sarah Avery, Duke Media Relations officer, at 919-660-1306 or at sarah(dot)avery(at)duke(dot)edu.

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Sarah Avery
Duke Media Relations
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