Transplantation options in the age of organ shortage and epidemiology and pathogenesis of primary and secondary glomerular diseases

 

Head of working group

  • PD. Dr. med. Christos Chatzikyrkou
  • Dr. med. Florian G. Scurt

 

team

  • Katrin Bose
  • Angela Ernst
  • Carl-Ludwig Fischer Fröhlich
  • Marius Früh
  • Maximilian Ganz
  • Dr. med. Ben Hammoud
  • Dr. med. Carolin Herzog
  • Verena Hirschfeld
  • Tamara Wassermann

 

Scientific profile

Our research activities focus on the allocation of marginal donor organs in the Eurotransplant area. Our work includes the collection of data on the donor, the donation process and the recipient as well as the analysis of macroscopic and histological characteristics of the donor organs. In this way, the factors that can lead to transplantation or rejection of a marginal organ can be determined. The aim of the project is to develop a clinical-pathological score system that enables transplantation physicians to make a reliable and, in particular, correct decision on the acceptance of a marginal organ during the limited period of the allocation process. This is of great importance in view of the organ shortage and the lack of clarity regarding the definition and quality assessment of marginal donor organs. In this context, we have investigated the possibilities of utilizing the living donor pool, e.g. through ABO-incompatible kidney transplantation or the acceptance of organs from older donors or from donors with hypertension.

Another focus is the pathogenesis of diabetic kidney disease. To this end, clinical data and preserved biological material from participants in the Roadmap study were used to investigate clinical and laboratory predictors.

A third focus is on primary and secondary glomerular diseases. Here we investigate the association of selected monocyte markers, which reflect important steps in their pathogenesis, with the activity of membranous focal segmental glomerulopathy and necrotizing ANCA-associated vasculitis. The clinical data of patients with vasculitis are analyzed separately.

Our final focus is on the evaluation of hospital data. Our current project is the evaluation of the cardiovascular and renal benefit of SGLT-2 inhibitors in patients with advanced renal insufficiency(stages 4 and 5 according to KDIGO) who were not included in the large pivotal trials.

 

Selected publications

  1. Scurt FG, Ewert L, Mertens PR; Haller H, Schmidt BMW, Chatzikyrkou C: Clinical outcomes after ABO-incompatible renal transplantation. A systematic review and meta-analysis. Lancet 2019 May 18; 393 (10185): 2059-2072.
  2. Chatzikyrkou C, Scurt F, Clajus C, Roumeliotis S, Mertens PR, Blume C, Haller H and Liakopoulos V. Predictors of outcomes of living kidney donation. Impact of age, sex and preexisting hypertension. Transplant Proc. 2019 Mar; 51(2):396-404.
  3. Scurt FG, Fischer-Fröhlich CL, Wassermann T, Ernst A, Schwarz A, Becker JU, Chatzikyrkou C. Histological and clinical evaluation of discarded kidneys in a European cohort of deceased brain death donor kidneys of marginal quality. J Nephrol. 2023 Oct 19. doi: 10.1007/s40620-023-01785-8. Online ahead of print.
  4. Scurt FG, Ernst A, Korda A, Fischer-Fröhlich Carl-Ludwig, Schwarz A, Becker JU and Chatzikyrkou C Clinical and histopathological characteristics of acute kidney injury a cohort of brain death donors with procurement biopsies. J Nephrol 2024 Jul;37(6):1599-1610
  5. Scurt FG, Wassermann T, Ernst A, Hammoud B, Mertens PR, Schwarz A, Becker JU and Chatzikyrkou C. Short-term outcomes after transplantation of deceased donor kidneys with acute kidney injury-a retrospective analysis of a multicenter cohort of marginal donor kidneys with post-explantation biopsies. Int Urol Nephrol 2022 Jul 9. doi 10.007/s1255-022-03277-3. Online ahead of print
  6. Scurt FG Ernst A, Hammoud B, Wassermann T, Mertens PR, Schwarz A, Becker JU, Chatzikyrkou C. Effect of creatinine metrics on outcome after transplantation of marginal donor kidneys. Nephrology (Carlton). 2022 Dec;27(12):973-982. doi: 10.1111/nep.14108. Epub 2022 Sep 20.
  7. Scurt FG, Ernst A, Fischer-Fröhlich CL, Schwarz A, Becker JU, Chatzikyrkou C. Performance of scores predicting adverse outcomes in procurement kidney biopsies from deceased donors with organs of lower-than-average quality. Transpl Int. 2023 Oct 12;36:11399. doi: 10.3389/ti.2023.11399. eCollection 2023.
  8. Ernst A, Regele H, Chatzikyrkou C, Dendooven A, Turkevi-Nagy S, Tieken I, Oberbauer R, Reindl-Schwaighofer R, Abramowicz D, Hellemans R, Massart A, Ljubanovic DG, Senjug P, Maksimovic B, Aßfalg V, Neretljak I, Schleicher C, Clahsen-van Groningen M, Kojc N, Ellis CL, Kurschat CE, Lukomski L, Stippel D, Ströhlein M, Scurt FG, Roelofs JJ, Kers J, Harth A, Jungck C, Eccher A, Prütz I, Hellmich M, Vasuri F, Malvi D, Arns W, Becker JU. 2-Step Scores with optional nephropathology for the prediction of adverse outcomes for brain-death donor kidneys in Eurotransplant. Nephrol Dial Transplant. 2024 Apr 17:gfae 093. doi: 10.1093/ndt/gfae093. Online ahead of print
  9. Scurt FG, Menne J, Brandt S, Bernhardt A, Mertens PR, Haller H and Chatzikyrkou C. Endostatin, soluble tumor necrosis factor receptor 1 and soluble tumor necrosis factor 2 cannot predict new onset of microalbuminuria in patients with type 2 diabetes. Diabetes Metab Res Rev. 2024
  10. Chatzikyrkou C, Menne J, Izzo J, Viberti G, Rabelink T, Ruilope LM, Rump C, Mertens PR and Haller H. Predictors for the development of microalbuminuria and interaction with renal function. J Hypertens 2017; 35 (12): 2501-09.
  11. Scurt FG, Menne J, Brandt S, Fischer A, Mertens PR, Haller H and Chatzikyrkou C: Systemic Inflammation Precedes Microalbuminuria in Diabetes. Kidney Int Rep 2019 Jun 21;4(10): 1373-1386
  12. Scurt FG, Menne Jan, Korda Alexandra, Haller H and Chatzikyrkou C. Effect of gender on transmission from normo-to microalbuminuria under angiotensin receptor blocker therapy in diabetes. J Diabetes 2020, Nov;12(11): 856-859
  13. Scurt FG, Menne J, Brandt S, Bernhardt A, Mertens PR, Haller H and Chatzikyrkou C: Monocyte chemoattractant protein-1 predicts the development of diabetic nephropathy, Diabetes Metab Res Rev 2022 Feb ;38(2)e3497
  14. Scurt FG, Hirschfeld V, Ganz M, Mertens PR, Chatzikyrkou C. Low levels of complement factor C3 at diagnosis can predict outcome in antineutrophil antibody associated vasculitis. J Nephrol. 2023 Jul 7. doi: 10.1007/s40620-023-01683-z. Online ahead of print.
  15. Scurt FG, Hammoud B, Bose K, Mertens PR, Chatzikyrkou C. ANCA Kidney Risk Score (AKRiS) Performance in a German Cohort of Patients with Histologically Confirmed ANCA-Associated Renal Vasculitis Kidney360. 2024 May 1. doi: 10.34067/KID.0000000000000459. Online ahead of print.

 

Cooperation partner

  1. Prof. Dr. med. Jan Jacob Menne. Siloah Hospital Hanover
  2. PD. Dr. med. Jan Ulrich Becker. Institute of Pathology University Hospital Cologne
  3. Ms. Angela Ernst, Technical University of Munich (from 01.03.2024)
  4. Carl-Ludwig Fischer Fröhlich, DSO Region Baden-Württemberg, Organizational Centre Stuttgart.
  5. Prof. Dr. med. Peter R Mertens. University Clinic for Renal and Hypertensive Diseases, Endocrinology and Diabetology, University Hospital Magdeburg
  6. Prof. Maria Stangou, 2nd Department of Nephrology, Hippocratic Hospital of Thessaloniki, Aristotelian University of Thessaloniki
  7. Dr. Yvonne Ziert, Ms. Leonie Theis, Institute of Biometry, Hannover Medical School

 

Third-party funding

  1. Markers for Subclinical Cardiovascular Risk Assessment(EU-MASCARA. Collaborative Project (CP). Large-scale intergrating project (IP). MHH Funded by: EU (HEALTH 2011. 2.4.2-2).
  2. ADVAGRAF vs. PROGRF once daily as a Rescue Therapy in Patients with Acute Rejection (APART-TRIAL) under Cyclosporin. MHH. Sponsor: Industry
  3. Diabetic nephropathy and chronic renal insufficiency. A study to evaluate the effect of Dapagliflozin on Renal Outcomes and Cardiovascular Mortality in Patients with chronic kidney disease. UKMD. Sponsor: Industry.
  4. Therapy of primary FSGS. Sparsentan study. UKMD. Sponsor: Industry
  5. Smart Prevent Diabetic Feet Study(SPDFS, German Clinical Trials Register DKRS, DKRS 00013798). UKMD. Sponsor: BMBF (PI: Prof. Mertens)

Contact: Prof. Mertens

Christos Chatzikyrkou