Research Group

  • Prof. Vasilios Papalois, Principle Applicant
  • Prof. Anthony Dorling, Co-Applicant
  • Dr Richard Smith, Co-Applicant
  • Dr Daqing Ma, Co-Applicant
  • Dr Karim Hamaoui, Collaborator
  • Dr Hailin Zhao, Collaborator


  • Imperial college London, London, UK


  • Improving Kidney Viability Before Transplantation - A Novel Approach Using Machine Organ Perfusion

The most serious problem facing patients on the waiting list for a transplant today is the shortage of kidneys for transplantation. Attempts to expand the donor pool has meant more use of kidneys from less suitable donors - so called 'marginal' donor organs - and organs from donors who die following cardiac and respiratory arrest.

Such efforts mean patients are more likely to receive a kidney but unfortunately these kidneys are also inherently pre-disposed to higher levels of 'injury' (sustained before and after these organs are transplanted). They subsequently experience more delayed function after transplantation, with poorer immediate function and lower long-term graft survival compared to non-marginal donor kidneys. Development of clots in the small vessels of the kidney (micro-thrombosis) and injury related to peritransplant ischaemia of the graft (ischaemic reperfusion injury) are two major causes of the post-transplant complications facing marginal kidneys.

It is these features of marginal allografts that prevent more marginal organs from being used in clinical practice. If methods can be developed to ameliorate such biological events, both micro-vascular thrombosis and reperfusion injury , it will open the avenue for an expansion of the potential donor pool and more organs would be available for transplant. Effective use of such donors is predicted to be able to increase the availability of organs by as 2-4 times the current numbers.

One of the main objectives of our work at Imperial College is to assess and modulate the viability of kidney grafts by prevention of thrombosis, and amelioration of reperfusion injury by utilizing machine organ perfusion and organ preconditioning. Part of this research has led to the development of novel blood thinning proteins to prevent localised blood clot formation in the kidney, and also the use of the noble anaesthetic gas xenon to lessen reperfusion injury. Both, the use of the blood thinning proteins and the use of xenon, have great potential to significantly improve transplant outcomes.

Progress Report