PathWest’s Fiona Stanley Hospital at forefront of world-first break through in organ donation research

World-first research out of Perth will slash the time it takes to find organ donation matches from days, down to four hours. A patient typically is placed on a waiting list for several years before they receive a life-changing call that an organ has become available for them. Before that call is made medical professionals can take more than 12 hours to test and determine what patient would be the best fit for the organ. With an national organ donation network in Australia, a donor in Brisbane could be matched to a patient Perth. By fast-tracking the critical matching process those organs can get to their recipients quicker, according to PathWest’s Fiona Stanley Hospital laboratory senior scientist Dr Dianne De Santis. At the helm of the research, Dr De Santis said the achievement is even more critical amid the coronavirus which created enormous hurdles in transferring organs after a drop in commercial flights. She medical professionals have had to rejig the organ donation waiting list to critical patients only during the pandemic. Dr De Santis achieved the feat by using DNA sequencing technologies by Oxford Nanopore to examine a complex gene group known as the human leukocyte antigen (HLA) complex. Through typing the HLA proteins of a patient and the donor, Dr De Santis not only found a faster method but also a more accurate prediction of if a organ would have long-term success for a recipient. Dr De Santis said HLA typing had been studied for half a century but technology hadn't been advanced enough to close the time gap for transplants. She said the previous method also didn’t examine the entire gene, meaning matches weren’t as accurate as they could be. “It’s method that doesn’t tell us exactly what the type of these antigens are. We're now looking at the whole gene, we're not looking at bits of the gene. This new Oxford Nanopore technology allows us to sequence these genes in four hour. So really quickly,” she said. “The way we've sequenced the DNA has enhanced dramatically. “It's really important to get those organs transplanted really quickly. There's a chance that if you transplant an organ 12 hours after the person has died, compared to six hours, the organ may not work,” she said. “The longer that time is the more chance that the organ won't work and the patient doesn't get any benefits... the poorer outcome for the patient.” Dr De Santis said the research was a massive step forward for minority ethnic patients who often have to wait significantly longer for a successful match due to shortage of suitably matched donors. These groups have rare HLA typing profiles and are generally ruled out as a recipients immediately, according to Dr De Santis. “Essentially we’re opening the door for these patients to be considered for a transplant, rather than being ruled out automatically, because we have access to more information from the donor cells,” Dr De Santis said. Dr De Santis said about 30 per cent of patients on the transplant waitlist are deemed “highly sensitised” because they have antibodies that could react with the donor’s HLA proteins. These patients, who were previously excluded from transplant options, are the main potential beneficiaries of this research. Dr De Santis said while it’s early days the research has garnered a large amount of interest internationally after it was published in the HLA medical journal. The research team as included research scientist Linh Truong, Clinical Immunologist Dr Lloyd D’Orsogna and Head of the Immunology Department Dr Patricia Martinez.