A multi-organ approach
Team leader: Pr Alexandre Loupy MD, PhD
The team includes several departments in kidney, heart, lung and liver transplantation, which are known as reference centers. Our consortium includes leading national kidney transplant centers totalling more than 530 transplants on average each year. The centers dedicated to heart transplant represent more than 80% of the overall national heart transplant activity (150 transplants on average each year) and the center dedicated to lung transplant is the leader in the Paris area (75 transplants on average each year). This is one of the largest multi-organ transplantation cohorts worldwide.
From Allo- to Xenotransplantation
The team has recently embarked on a new research avenue aiming to transfer our precision diagnostic approach from allo- to xenotransplantation in order to decipher the immunological process involved in the xenoimmune response. Multimodal phenotyping of xenografts is a necessary step to bring xenotransplantation from experimental investigation to clinical trials in living human recipients. For this purpose, our team, will benefit from established scientific collaborations with leading teams in xenotransplantation, to transfer and adapt our precision medicine approach from allo to xenotransplantation.
Over time, we have developed a particular scientific approach closely combining clinical investigations and statistics. The probabilistic mathematical tool is used in an integrative thinking approach, coupled at many levels with questions, insights and clinical investigations.
We called this approach « integrative epidemiology ».
This approach received the “Grand Prix de l’Académie des Sciences 2013” and the "Grand Prix de l'Académie de Médecine 2018" by the French Academy of Medicine in Paris (France).
The rapid advances in medicine and sciences led to increased specialisation. The integrative epidemiology sets up an opposite approach where medical specialties and fundamental sciences are centralised around epidemiology.
Data Driven Science
So far, many results derived from large registries (UNOS in the US, Eurotransplant, National French Agency for Organ Procurement). They have a high value for descriptive purposes (prevalence and incidence), they do not provide per se insights in pathogenesis, risk prediction and personalised transplant medicine.
Our approach uses exceptionally large prospective unselected cohorts with a very high level of detail (deep phenotyping), to test cutting-edge technologies with powerful and robust methodological tools.
The large quantity of information gathered from thousands of patients at multiple points in time allows us to take advantage of big data / smart data approach.
Ibox : Prediction system for renal allograft loss
This is the first international study of risk prediction in kidney transplant recipients
Developed and validated across several large independent populations and in randomised controlled clinical trials. The iBox score represents a novel integration of demographic, functional, histological, and immunological factors that can be implemented in routine clinical practice. It has potential to upgrade the shared decision making process for transplant patients and represents a valid and early surrogate endpoint for clinical trials and drug development in transplantation.