COVID-19 and Transplantation

COVID-19 and Transplantation: Finding Answers Through Research with Dr. James Lan

As more becomes known about COVID-19, the need for knowledge specific to transplant recipients becomes increasingly important, especially given their unique immunosuppressed state. In British Columbia alone, more than 5,200 solid organ transplant recipients are living through the pandemic and navigating life in the era of COVID-19.

The Transplant Research Foundation, in collaboration with the VCHRI’s COVID-19 Research Fund, is supporting Dr. James Lan’s new project which will look specifically at the risks, implications and outcomes of COVID-19 in transplant recipients. We spoke with Dr. Lan on his study “Comprehensive Immune Profiling of Solid Organ Transplant Recipients with Covid-19”.

Tell us about your connection to transplantation and your interest in research?
During my training I was amazed by how rapidly and effectively transplantation can restore both the organ function and health of patients with kidney failure. When I learned that rejection is the most common problem, which leads to premature organ failure, I decided to pursue a career in studying transplant immunology to help develop new solutions to treat this complex and growing problem.

You were recently awarded funding for your project that seeks to determine immune response to COVID-19 in transplant recipients. What is this project about?
First, I would like to extend my special thanks and gratitude for the support from VCHRI and TRF to fund this important study. Traditionally, we know that transplant patients are susceptible to infection due to their need to take anti-rejection medications. However, what is interesting about the COVID-19 infection is that it can lead to an exaggerated hyperactive immune response (cytokine storm), which is particularly lethal. The main goal of this project is to understand how the immune response to COVID-19 differs between organ transplant patients and the general public who are not immunosuppressed. We will also explore whether specific immune signatures, as measured by our lab tests, are associated with poor outcomes in those with infection. Ultimately, we hope this data will help transplant physicians better manage immunosuppressive medications in patients with COVID-19.

What is the scope of transplant patients involved in this study and will there be multi-site collaboration?
Our goal is to recruit all organ transplant patients who have been diagnosed with COVID-19. We will study patients’ immune systems by performing three cutting-edge laboratory tests on blood collected from participants. There is significant interest from our colleagues outside of BC to participate in this work so we will be expanding our study into a multi-center collaboration.

Why is this research so important to the health and welfare of transplant patients and their families?
Currently, it is still not clear how immunosuppressive medications should be adjusted in transplant patients with COVID-19. Intuitively, it makes sense to decrease the level of immune suppression in patients with active infection. However, we are also mindful of the deadly hyperactive immune response that has been associated with this virus. This clinical dilemma is difficult to resolve without directly assessing the patient’s immunity. What is unique about our study is that we will use three emergent lab tests to assess different components of patients’ immune system. We hope this data will help to shed light on the complex interplay between infection and immunity, with the goal of informing practical strategies for immunosuppression management.

Although this project is still in the early stages, what further avenues do you believe may stem from this work?
If our strategy is successful, we believe the three tests could be used to “track” the immune system of patients with COVID-19, allowing physicians to tailor immunosuppressive medications based on real-time test results. This approach could also be applied to study transplant patients’ immune response to a vaccine, when one becomes available in the future.

You believe strongly that patients should have a voice in research. How are you planning to engage patients in this project?
We strongly believe that patient engagement is critical to the success of any research project. To this end, we will be working with BC Transplant, TRF, VCHRI, and the Kidney Foundation to look for interested patient partners to join our team as we continue to refine the study proposal and begin implementation.

A sincere thank you to Dr. Lan for offering his insight on the specific challenges transplant recipients face related to COVID-19 and sharing how his research is working to address these challenges.

The TRF is only able to support Dr. Lan’s COVID-19 project through the generosity of our donors. Please help by donating today