Dr Noel Carter’s research has the potential to save thousands of lives by increasing the number of organs available to transplant patients. The techniques he and his team have pioneered make it possible to use organs that were previously deemed unsuitable for transplantation. The team developed a new cooling device that improves the performance of newly transplanted kidneys taken from ‘Category II’ donors.
Dr Carter, a Senior Lecturer in Molecular Biology in the Department of Pharmacy, Health and Wellbeing, explains: “Category II donors were often referred to as non-heart-beating donors. Today we call them DCD donors – or Donors after Circulatory Death – which means they have suffered cardiac arrest. Organs from such donors are not normally considered to be of good enough quality for transplantation. That’s because they are taken from bodies where there has been no owing oxygen, and so they can become damaged.
“We realised that if we could find a way of making these organs usable, we could significantly increase the donor pool. What we have been able to do is find a way to improve the efficiency of these organs – effectively pushing the boundaries of what can be achieved from what you might call ‘marginal donors’.”
The work pioneered at Sunderland has now been taken up by other universities – with the ultimate aim of bridging the gap between supply and demand. It’s estimated there are around 7,000 patients on the waiting list for donor kidneys – but only about 2,000 organs available for transplant. Dr Carter adds: “Our entire focus at Sunderland has been to increase the number of organs available for donation and I am proud of what has been achieved. Our work has led to what has become a national approach fronted by other institutions, including Cambridge University.”
Dr Carter worked in collaboration with Professor David Talbot, Consultant Transplant Surgeon at Newcastle’s Freeman Hospital and also a Visiting Professor at the University of Sunderland. As well as their cutting-edge research into improving the functional quality of donor organs, Dr Carter has been able to demonstrate that even kidneys that have tumours can be transplanted. When a tumour is discovered on a kidney, patients often opt to have their entire organ removed as the body is able to function perfectly well with one kidney.
"Our work has led to what has become a national approach fronted by other institutions, including Cambridge University.”
Traditionally, these kidneys were discarded. However, Dr Carter – working with Dr Anne Cunningham, now at the University of Brunei Darussalam, was able to show that they could have a ‘second life’. He explains: “We have been able to demonstrate that you can remove the tumour and transplant the remaining kidney – and it has proven to be a viable organ. There’s such a shortage of donor organs that, for some patients who have been on a waiting list a long time, especially those facing a high risk of mortality, these kidneys could mean the difference between life and death.”
Dr Carter has also worked in close collaboration with partners at Newcastle University to pump new life into hearts previously considered unsuitable for transplantation.
“We demonstrated enough evidence in our results from restarting pigs’ hearts after several hours of being clinically dead to be able to begin clinical testing on human hearts that are, at present, considered too marginal to be used for transplant or as a source of heart valves. Heart surgeons have to be 100% positive that this vital organ is going to work before transplantation, which is why a number of them end up not being used.
"Our research wants to take those rejected hearts, get them restarted, carry out echocardiograms and tests in a sterile environment to check activity and show them to be in perfect working order. We believe then a proportion could be reconsidered for transplantation.”