• Date: June 05, 2020

Since the first successful organ transplant in 1954—a kidney from the patient’s identical twin—organ donations have extended and saved hundreds of thousands of lives.

Thanks to the dedicated efforts of research groups across the globe, these procedures are continually improving, thus ensuring that more and more patients can benefit from them with fewer complications. In honour of World Transplant Day, celebrated annually on 6th June, we spoke to the innovators behind two CaixaImpulse projects to shine a light on their technologies that could improve transplant patients’ quality of life.

Dr. Francesc E. Borràs from Germans Trias i Pujol Research Institute leads the project FIBROKIT, a urinary diagnostic kit to measure renal fibrosis, which is one of the major causes of graft-loss in kidney transplant patients.

Dr. Mònica Mir is a nanobioengineering researcher at IBEC and leader of the project ISCHEMSURG, an electrochemical sensor to monitor ischemia, or an inadequate blood supply, in transplanted tissue.

Both projects were born following conversations between the researchers and medical doctors, and thus address common transplant complications.

MONITORING SCARS TO KEEP KIDNEYS HEALTHIER

Kidney transplants are becoming more and more common these days. How does fibrosis affect patients?

Fibrosis, or the damaging buildup of scar tissue, is quite a common long-term complication following a kidney transplant. After five years, roughly 15% of patients develop fibrosis, a figure that increases at 10 years follow-up. Many eventually need a second transplant, as severe fibrosis can cause the kidney to stop functioning properly. But there are many different factors that can affect this, which is exactly why we need a good way to monitor it.

How is fibrosis usually monitored?

At the moment, fibrosis is monitored via a renal biopsy. This is a highly invasive procedure, so it can’t be performed very often. If any abnormality is detected in patients’ routine checkups, then a biopsy is performed. What we want to do is monitor fibrosis during these checkups, avoiding the need for an invasive biopsy. Our overall goal is to detect fibrosis long before it ever becomes a problem, and keep the organs working properly and in good health for longer.

And that’s where FIBROKIT comes in, right? What exactly is FIBROKIT?

It’s an idea that started after conversations with nephrologists interested in transplantation, and in particular, in preventing the complications caused by fibrosis. In response, we created FIBROKIT, a diagnostic kit to monitor fibrosis via a urinary biomarker.

This is a non-invasive technique that allows patients to be monitored much more frequently. In scientific terms, we have identified a protein which is highly expressed in the urine of patients with severe fibrosis.

If all goes according to plan, FIBROKIT won’t be difficult to implement. It’s an ELISA-based technology, which is already routinely used in the clinical setting.

How did CaixaImpulse help this project?

CaixaImpulse helped us a lot. First of all, the funding that we received was extremely important to keep the project moving forward. But it also gave us a broader vision in terms of the translationality of our research, as well as a better understanding of the market, industry, and writing and presenting a patent with a minimum guarantee of success.

A MICROSENSOR TO MORE RELIABLY DETECT ISCHEMIA

How did the ISCHEMSURG project take shape?

The project was born after speaking with medical doctors who told us about the problems they were having monitoring postoperative ischemia—an inadequate supply of blood—in transplanted tissue. There are existing techniques to detect ischemia, but they are expensive, they often give false positives, and can be highly invasive. As a result, many doctors have stopped using them, and have instead reverted to the classical methods, that is, assessing colour and temperature to decide if vascularization has taken place.

But this method is not sufficient in assessing micro-vascularization. We are talking about a 21st-century procedure using 20th-century monitoring techniques. The fate of such a complex operation should not be left to subjectivity. And that’s why we have developed an easily-implanted microsensor that can detect these abnormal vascularizations.

Can it be used to monitor vascularization of tissue that doesn’t come from the patient?

Yes, in fact, what we are monitoring is the perfusion in the vascularization of two tissues, so the origin of the other tissue doesn’t matter. If perfusion is not well-performed between the two tissues in one or two days, the transplanted tissue is degraded. In the case of organ transplantation, the organ can fail, so it’s really important to get this right.

How will this technology be used?

It has been designed for post-operative use in hospitals, because these problems arise in the first few hours after surgery. It will be inserted with a needle which can then be taken out so that it’s more comfortable for the patient, and when the monitoring has finished, the sensor can be removed from the tissue very easily.

What did the project gain from CaixaImpulse?

It was an excellent platform, first of all to improve our technology. But I think that the main power that this fellowship has is what you can learn. They give you a lot of knowledge in business and in investors, and help you to build a strong network.

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