Overview
A transplanted lung can start to fail for many different reasons, and that is the problem this laboratory is built around. Two people whose breathing tests look identical can have completely different things happening inside the lung. One may have an immune reaction that could still be stopped. Another may have scarring that is already permanent. There is often no way to tell them apart, so both are treated the same way.
We are trying to change that. Our work combines samples collected from transplant recipients over many years with laboratory methods that show which genes are switched on inside the lung, which immune cells are present, and what those cells are doing. The aim is to identify the specific process damaging a particular lung, early enough that something can be done about it.
The work is organized around five areas.
- Primary graft dysfunction: severe injury in the first three days after surgery, and the immune cells that cause it.
- Infection: why the same infection is harmless in one recipient and damaging in another.
- Acute lung allograft dysfunction: sudden drops in lung function, and which ones turn into permanent damage.
- Chronic lung allograft dysfunction: the gradual loss of lung function that remains the main limit on long-term survival.
- AI2 score: a way of measuring, from a small airway sample, whether inflammation is actively happening right now.
Approach
The program integrates longitudinal clinical cohorts with airway sampling, genomics and transcriptomics, immune phenotyping, human genetics, epithelial biology, experimental models, computational analysis, and clinical trials. The intent is that an observation made in a patient can be traced to a mechanism, tested experimentally, validated in an independent group of patients at other centers, and eventually matched to a therapy.
Biorepository
The work is supported by a lung transplant biorepository holding more than 30,000 specimens, each linked to detailed clinical information collected over years rather than at a single visit. Specimens include bronchoalveolar lavage fluid, which is collected by washing a small area of the lung and drawing the fluid back, along with blood cells and plasma, airway brushings, and lung tissue biopsies.