The laboratory of Scott Palmer, MD, MHS, scientific director for the Lung Transplant Program, is focused on understanding the mechanisms of lung rejection and prevention of post-transplant infection.
In addition, our research group is studying clinical and basic mechanisms by which gastric reflux impairs post-transplant lung function. Through these and other studies, researchers at Duke are working to develop new and highly effective therapies that improve and extend the lives of our lung transplant patients.
Current research studies being conducted by the Duke Lung and Heart-Lung Transplant Program are designed to advance our understanding of the causes of acute and chronic rejection.
Recent data suggests that patients with certain genetic variants may have a decreased immune response to their transplanted lungs and, therefore, may be protected from developing rejection.
We are, therefore, collecting genetic information (DNA) obtained from lung transplant recipients during routine transplant clinic visits.
We are also recording all transplant related medical events in our research database so we can look for patterns of complications after transplant. We will use the DNA to evaluate whether genetic differences increase or decrease one’s risk for rejection or other complications after lung transplant.
The body’s immune system is very complex and plays a primary role in transplant rejection. It is not yet clear which parts of the immune system directly contribute to acute or chronic rejection.
We are therefore examining proteins and other immune markers in the blood of lung transplant recipients and looking for patterns between immune markers and rejection.
Our ultimate aim is to identify markers that consistently predict acute or chronic rejection.
Primary graft dysfunction (PGD) is an acute lung injury that develops in roughly 15 to 25 percent of lung transplant recipients. The onset of injury is immediate, within 24 to 72 hours following transplant.
Of concern, transplant recipients with PGD may be at an increased risk of developing chronic rejection.
In this study, we are examining genetic and immune markers in both the recipient and donor to determine whether they play a role in PGD. Additionally, we are recording medical events occurring within three days after transplant to evaluate their potential relationship with PGD.
Scott Palmer, MD, MHS