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Groningen Institute for Organ Transplantation (GIOT)

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Transplantation is a lifesaving therapy for patients suffering from end stage organ failure. The UMCG is the most prominent transplant center in the Netherlands and is the only center licensed to perform all forms of solid organ transplantation. Transplantation is a multidisciplinary treatment in which specialists work closely together. To ensure optimal outcome, organ-specific knowledge in terms of both physiology and anatomy is essential. In addition, knowledge about donor management and optimization, donor organ preservation and post-transplantation management of issues such as ischemia/reperfusion injury, rejection and infections, long-term quality of life are relevant aspects that require continuous research and development.  
Integration of experience and knowledge within the GIOT program results in better understanding the chain of events during transplantation, improvement of translation of basic research to clinical applications, and increases the visibility of the UMCG as top institute providing high-quality care for patients in need of an organ transplant. The impact of an organ transplant on patients is enormous. It not only increases their quality of life, but also their life expectancy. Moreover, healthy ageing applies not only to patients but also to their implanted grafts; patients and grafts are both subject to differential ageing processes for which individual strategies  are needed in terms of immunosuppressive drugs, nutrition and lifestyle.  

Scientific and Societal output   Dissertations  

See dissertations of GIOT on horafinita.nl

Principal Investigators   Programme Leaders   Description of the Programme  

The program aims to increase the knowledge required to achieve improvements in 1) management of the donor and optimization of donor organ quality, 2) preservation of the organ, 3) reducing early organ damage following implantation (by for example ischemia-reperfusion injury), 4) reducing chronic graft dysfunction, and 5) long-term quality of life. These topics cover all important aspects in the chain of events in solid organ transplantation.  

Donation: The increasing need for transplantable organs forces transplant professionals to accept organs from suboptimal donors (so called extended criteria donor or ECD). Preserving or even improving organ quality during the pre-donation phase by evidence-based donor management, donor pre-conditioning, and optimization of retrieval techniques are essential aspects of organ transplantation. GIOT research aims to improve outcome after transplantation of organs from suboptimal donors and promote wider usage of such organs.  
Preservation: More sophisticated techniques such as cold and normothermic machine preservation will be needed, instead of generally used static cold storage, to improve functional quality of ECD organs. One benefit of normothermic machine preservation is that it allows functional testing and pharmacological conditioning of the organ. The UMCG is a world leading institute in the development of methods for preservation of heart, lung, liver, kidney and small bowel, which has been further enhanced by integrating this research focus in GIOT. 
Short-term effects: Graft reperfusion is a critical part of the chain of events during transplantation. Reperfusion injury may negatively affect organ quality and function, which adds to any pre-existing injuries, especially in ECD organs. Novel strategies to decrease the injurious processes as well as to improve repair processes are examined and developed within GIOT  
Long-term effects: Even after a successful transplantation, there is no guarantee for good long-term function. Various processes may affect organ function and survival, including graft rejection, recurrent disease, and graft fibrosis leading to decline in function. In addition, long after transplantation recipients may suffer from the side effects of immunosuppression. Research in these areas improves long-term graft and patient survival and correspondingly quality of life.

Mission  

To improve outcome after solid organ transplantation by providing a comprehensive program of translational and clinical research with the main focus on improving the availability of suitable donor organs and improving long term survival and quality of life after transplantation.

Relevance to Healthy Ageing  

Organ transplantation has many aspects that have a strong and prominent link with healthy aging. First, organ transplantation is a life saving therapy for several types of organ failure. Due to the increasing success rates of organ transplantation, more and older patients are being accepted for transplantation. In addition, organs from older donors are increasingly accepted for transplantation because of the widening gap between donor organ demand and supply. Some recipients are living with a donor organ that is much older than the recipient him/herself. This makes organ transplantation a very interesting “model” to study aging of solid organs. On the other hand, the chain of events in transplantation, leading to an accumulation of injuries of various origins also results in accelerated aging of the donor organ. These aspects make organ transplantation a clinically relevant, but also scientifically very interesting subject in the field of healthy ageing.