Research and Clinical Trials
Researchers within the Division of Transplantation at the University of Maryland Medical Center are committed to investigating new ways to advance the science of transplantation and ensure better futures for patients in need of transplant or for those who are already living with organ transplants.
The research within the Division of Transplantation falls into several categories:
- Inducing tolerance - teaching the body to accept a foreign graft, such as a transplanted organ, without rejection and with limited or no immunosuppression.
- Immunosuppression medications and medication management - testing the latest medications or combinations of medications to prevent rejection while reducing the "pill burden" on patients and creating protocols that demonstrate long-term success with fewer side effects.
- Increasing the number of available donor organs - through tissue regeneration and systematic sourcing of available organs.
- Advancements in surgical technique - use of new operative tools, materials and techniques, including the single-incision laparoscopic surgery used on living kidney donors.
- Using bone marrow-derived stem cells to decrease rejection - could help eliminate need for immunosuppression in all types of organ recipients.
- Bridge-to-transplant technology - medical devices used to help patients who are in need of transplant but either not at the top of the wait list or without an available donor organ.
Advances in Hepatitis C Treatment
University of Maryland Medical Center (UMMC) is one of the country's premier hospitals treating patients with liver failure. Our doctors and researchers help to discover new medications and treatment options for many liver diseases, including hepatitis C.
Today, the U.S. Food and Drug Administration (FDA) is approving new medications that will treat cirrhosis of the liver faster, easier and more effectively in patients with liver damage caused by chronic hepatitis C.
Previously, drugs for hepatitis C were protease inhibitors, which means they attacked a certain part of the hepatitis C virus. In late 2013, a new category of medicines came out, called polymerase inhibitors. These medications attack a different part of the hepatitis C virus.
Polymerase inhibitors are more effective than any other drug so far. Patients experience high cure rates, even when they have cirrhosis of the liver, which has been difficult to treat. We offer these new medications to all patients who have hepatitis C.
This new category of drugs is safe and has limited side effects. They also:
- Do not interact with other drugs as previous medications have
- Have higher cure rates than in the past
- Do not cause rashes, anemia, itching or burning anal pain
- Cause less fatigue than previous medicines for hepatitis C
Many transplant surgeons are excited about the new medical treatments for hepatitis C because these medications make both pre- and post-transplant care more effective. They are also leading to better long-term outcomes for patients.
We offer all patients with hepatitis C the opportunity to live free of the virus with the new medications. A dedicated nurse and pharmacist will help patients with issues surrounding insurance coverage of these new drugs.
The advantages of the new medications include:
- Fewer interactions with immunosuppressant medications: Previous hepatitis C drugs had major drug interactions with immunosuppressant medications. These interactions made these medications problematic for patients with a transplant.
- Preventing cirrhosis: Cirrhosis caused by hepatitis C is the No. 1 cause of liver transplant. Medications like ones that have come out in the last few years will help treat patients with hepatitis C earlier in the disease process. This will lower the number of patients who need a liver transplant because of hepatitis C.
- Saving lives after transplantation: For a patient who has hepatitis C, the hepatitis will always come back, even after a liver transplant. However, these new medications can eliminate hepatitis C before transplant. This can prevent the hepatitis virus from destroying the transplanted liver. By eliminating hepatitis C in patients who have cirrhosis before they have a transplant, we do not have to treat hepatitis C after transplant because the virus is already cured. Learn more about liver transplant.
As part of an academic medical center, our Liver Center has participated in several clinical trials involving direct acting antivirals (DAAs). Learn more about our research and clinical trials.
To schedule a conversation with the liver team, please call 1-410-328-5941.
For referring physicians: To refer a patient or get more information, please call 1-800-373-4111. A physician service representative from Consultation and Referral Services will direct your call to the appropriate physician or department.
For more details, please visit our section for referring physicians.
Research in Lung Healing
Clinicians and scientists are invested in improving the outcomes of patients with acute and chronic lung diseases. Research is being conducted through the Lung Healing Program, both in laboratory settings and with UMMC patients who could benefit from the latest in lung disease treatment.
Collaborators in the Lung Healing Program include cardiothoracic surgeons, critical care doctors, trauma surgeons, nurses within these specialty areas, and researchers from the University of Maryland School of Medicine.
Learn more about ongoing research within the Lung Healing Program.
Patients with heart failure have heart pumps and ventricular assist devices (VADs) that allow their hearts to keep beating. Patients with kidney failure have dialysis to clean the toxins from their blood. Diabetics have insulin to correct the under performance of their pancreas. But there are no options other than transplantation for patients with liver failure, and unfortunately more people are in of need of liver transplants than there are donor organs available.
Dr. John LaMattina, assistant professor and director of the University of Maryland Medical Center’s living donor liver transplant program, is committed to finding new options for patients with end-stage liver disease. His first step was to work with colleagues in the Division of Transplantation to establish the largest adult living donor liver transplant program in the state of Maryland, which enables close friends or relatives to donate part of their liver to their sick loved one after thorough a examination and extensive physical evaluation. This living donor surgery is designed to help transplant patients earlier in their liver failure so that they recover more quickly and do not become sicker while awaiting a deceased donor organ.
In addition to his clinical solutions for maximizing available livers, Dr. LaMattina fosters a passion for basic science research, which culminated during his training years in a fellowship in the Transplant Biology Research Center at Massachusetts General Hospital in Boston where he studied transplant immunology and tolerance of transplanted tissue.
Now with a lab of his own, Dr. LaMattina uses a pre-clinical model to investigate the possibility of stripping native cells from donor livers, leaving only the translucent scaffolding of the liver, and recellularizing them with stem cells from a needy recipient. If perfected, this procedure could eliminate deaths caused by the shortage of livers available for transplantation. The science is complex, but the concept is fairly simple, like gutting the inside of a home and rebuilding the floor plan.
Imagine if patients could become both their own donor and recipient. It would look something like this: patient donates his/her own healthy stem cells. Physician scientists inject stem cells into an empty liver scaffold where cells multiply over a few weeks until they have filled the scaffold and regenerated a full liver. Surgeons would transplant that newly recellularized liver into the donor-recipient.
The risk of rejection would be much lower since the cells came from the recipient’s own body. And the wait time to transplant would be weeks instead of months, requiring just a few weeks to harvest stem cells and recellularize a liver scaffold.
Research is in the early stages, but Dr. LaMattina believes he will see significant advancements in the next five to 10 years with increased funding and research support.
Clinical trials play a crucial role in advancing the science of medicine through human trials. Patients participating in clinical trials often have access to the very latest medications and protocols that may not otherwise be available. Clinical trial participants are actively contributing to the advancement of science as their participation helps perfect future treatment options for transplant patients.
Adult Tissue-Derived Stem Cells and Tolerance Induction in Nonhuman Primates for Vascularized Composite Allograft Transplantation
Congressionally Directed Medical Research Programs (CDMRP)
Vascularized Bone Marrow Regulates Alloresponses to Vascularized Composite Allografts
Dept. of Defense – AFIRM II
Upregulation of bone marrow compartment mediated immunomodulation for vascularized composite allografts
Congressionally Directed Medical Research Programs
Restorative Transplantation Research Cooperative Agreement
Research Study of ATG and Rituximab in Renal Transplantation (RESTARRT) (ongoing, not recruiting)
Immunosuppression With Antithymocyte Globulin, Rituximab, Tacrolimus, Mycophenolate Mofetil and Sirolimus, Followed by Withdrawal of Immunosuppression, in Living-donor Renal Transplant Recipients
Belatacept in Renal Transplantation with Intermediate Risk Maryland Aggregate Pathology Index (MAPI) Scores (ongoing, not recruiting)
A 12 Month, Single-center, Non-randomized, Open-label Study of Outcomes of Intermediate Risk Maryland Aggregate Pathology Index (MAPI) Scores in de Novo Renal Transplant Recipients
Advancing Renal TRANSplant eFficacy and Safety Outcomes With an eveRolimus-based regiMen (TRANSFORM) (TRANSFORM) (ongoing, not recruiting)
A 24 Month, Multicenter, Randomized, Open-label Safety and Efficacy Study of Concentration-controlled Everolimus With Reduced Calcineurin Inhibitor vs Mycophenolate With Standard Calcineurin Inhibitor in de Novo Renal Transplantation
Efficacy and Safety of Everolimus in Liver Transplant Recipients of Living Donor Liver Transplants (ongoing, not recruiting)
A 24 Month, Randomized, Controlled, Study to Evaluate the Efficacy and Safety of Concentration-controlled Everolimus Plus Reduced Tacrolimus Compared to Standard Tacrolimus in Recipients of Living Donor Liver Transplants and Long Term Extension to Evaluate the Efficacy and Safety of Concentration-controlled Everolimus Plus Reduced Tacrolimus Compared to Standard Tacrolimus in Recipients of Living Donor Liver Transplants in Japan
Reduce the Severity of DGF in Recipients of a Deceased Donor Kidney (currently recruiting)
A Multicenter, Prospective, Double-Blind, Randomized, Placebo-Controlled, Phase 3 Study of BB3 to Reduce the Severity of Delayed Graft Function in Recipients of a Deceased Donor Kidney
CCFZ533X2201 - PoC Study in de Novo Renal Transplantation (currently recruiting)
A 12-month Randomized, Multiple Dose, Open-label, Study Evaluating Safety, Tolerability, Pharmacokinetics/Pharmacodynamics (PK/PD) and Efficacy of an Anti-CD40 Monoclonal Antibody, CFZ533, in Combination With Mycophenolate Mofetil (MMF) and Corticosteroids (CS), With and Without Tacrolimus (Tac), in de Novo Renal Transplant Recipients
QPI-1002 for Prevention of Delayed Graft Function in Recipients of an Older Donor Kidney Transplant (ReGIFT) (ongoing, currently recruiting)
A Phase 3, Randomized, Double-blind, Placebo Controlled Study to Evaluate the Efficacy and Safety of QPI-1002 for Prevention of Delayed Graft Function in Recipients of a Donation After Brain Death Older Donor Kidney Transplant
A Study to Assess the Efficacy and Safety of ASKP1240 in de Novo Kidney Transplant Recipients (ongoing, not recruiting)
A Phase 2a, Randomized, Open-label, Active Control, Multi-Center Study to Assess the Efficacy and Safety of ASKP1240 in de Novo Kidney Transplant Recipients
PKD Clinical and Translational Core Study (ongoing, currently recruiting)
The Baltimore Polycystic Kidney Disease Clinical and Translational Core Study
To Compare the Effects of Immediate-release Tacrolimus and Astagraf XL on Donor-Specific Antibody (DSA) Formation and the Development of Immune Activation (IA) in de Novo Kidney Transplant Recipients (ASTOUND) (ongoing, not recruiting)
Astagraf XL® to Understand the Impact of Immunosuppression on De Novo DSA Development and Chronic Immune Activation in Kidney Transplantation
Non Invasive Blood Test to Diagnose Acute Rejection AFTER Kidney Transplantation (DART) (ongoing, not recruiting)
Circulating Donor-Derived Cell-free DNA in Blood for Diagnosing Acute Rejection in Kidney Transplant Recipients
T-SPOT.CMV and T-SPOT.PRT Diagnostic Assays (PROTECT) (ongoing, currently recruiting)
A Prospective Observational Trial to Evaluate the Correlation of T-SPOT® Response to CMV Infection and T Cell-mediated Acute Graft Rejection
A Study of PRT-201 Administered Immediately After Radiocephalic Arteriovenous Fistula (AVF) Creation in Patients With Chronic Kidney Disease (CKD) (PATENCY-1) (ongoing, not recruiting)
Multicenter, Double-Blind, Placebo-Controlled Study of PRT-201 Administered Immediately After Radiocephalic Arteriovenous Fistula Creation in Patients With Chronic Kidney Disease
Evaluation of Anti-platelet Factor 4/Heparin Antibodies in Hemodialysis Patients (currently recruiting)
Evaluation of Anti-platelet Factor 4/Heparin Antibodies in Hemodialysis Patients Implanted With the GORE® Hybrid Vascular Graft Versus Non-heparin Bonded Synthetic Vascular Grafts