Risks Factors, Mechanisms, and Manifestations of Chronic Lung Allograft Dysfunction (CLAD)

The study network, initially funded through NIAID, leverages the clinical and research expertise of five top lung transplant programs to improve patient outcomes through clinical, and translational studies to understand and prevent post-transplant infection and chronic allograft dysfunction, the leading cause of death in lung transplant recipients. Hopkins-led projects include studies of transcriptional regulation of CMV specific T lymphocyte immunity, and the impact of frailty metrics in post transplant outcomes.

Funding: U01 AI 113315  07/01/14-06/30/20
JHU Faculty Team Members: Jonathan Orens, Pali Shah, Robin Avery ( ID), Jonathan Schneck ( Immunology)

Cell Free DNA as an early marker of lung allograft injury

In groundbreaking work, through the Laboratory of Transplantation Genomics at NIH, Dr, Enoh-Agbor has demonstrated the predictive utility of donor derived cell free DNA as a sensitive marker of early graft injury, that can precede and predict clinical antibody mediated rejection, as well as early mortality following lung transplantation. Through the multi center Genomic Research Alliance for Transplantation, we will further determine how measurements of Cell-Free DNA can be used to reliably predict injury from acute rejection, select infections and other graft injury phenotypes in heart and lung transplantation.

Funding: NIH- HHSN268201500048P (Orens/Valentine)  – 9/9/15–9/1/20
JHU Faculty Team Members: Sean- Enoh Agbor, Jonathan Orens, Pali Shah

Improving outcomes in Cystic Fibrosis Lung Transplant Recipients

We are member site for the Cystic Fibrosis Lung Transplant Consortium, a 10 center consortium whose mission is to advance outcomes in cystic fibrosis patients who may need or have received lung transplant.  Current Hopkins-led projects include a transition initiative to identify and develop best practices in the referral through evaluation process of transplant candidates, and research in understanding how psychosocial assessments are integrated into the transplant referral and evaluation decision making

Funding: Cystic Fibrosis Foundation SHAH16A3 (Shah) – 1/1/2017-12/31/2019
Faculty Team Members: Christian Merlo, Pali Shah, Noah Lechtzin, Errol Bush (Surgery), Kristen Riekert 

Microbiome and Host Response of CLAD in Cystic Fibrosis patients

In collaboration with the University of Pennsylvania and University of Pittsburgh. We are examining the role of the lung transplant recipient microbiome and associated host responses towards the development of Chronic Lung Allograft Dysfunction. Dr. D’Alessio leads the Hopkins mechanistic core of this project to examine the host macrophage immune response in response to distinct microbiome phenotypes

Funding: Christ18AB0 – 1/1/2019-12/31/2020
Faculty Team Members: Franco D’Allesio, Pali Shah, Christian Merlo,

Cohort Studies of Lung Transplant Outcomes in Cystic Fibrosis and other Diseases

This series of studies utilizes data from the United Network for Organ Sharing

(UNOS) and the Cystic Fibrosis Foundation Patient Registry to determine how various pre and post transplant risk factors such as renal function and lung allocation score impact clinical outcome after lung transplantation.

Team:  Christian Merlo, Errol Bush ( Surgery), Pali Shah

Early perioperative outcomes after lung transplantation. Clinical and molecular epidemiology of acute kidney injury after lung transplant

Since 2007, we have been members of the Lung Transplant Outcomes Group –  a Multicenter Consortium led by the University of Pennsylania that has defined clinical and molecular predictors of primary graft dysfunction after Lung transplantation. With over 25 manuscripts from this series of work, the group is currently focusing on clinical risk factors and biomarkers that predict the risk of acute kidney injury immediately following lung transplant.

Funding: NIH- Ro113-302 (Shashaty) – 09/01/16-08/31/21
Hopkins PI: Pali Shah

Novel Therapeutics/ Clinical Trials:

The lung transplant group is been involved several clinical trials of  new treatments for lung transplantation. Recent and ongoing studies are below:

BOSTON 1-2

• A Phase III, Prospective, Multicenter, Randomized, Controlled Clinical Trial to Demonstrate the Effectiveness and Safety of Liposomal Cyclosporine A (L-CsA) Inhalation Solution Delivered via the PARI Investigational eFlow® Device in the Treatment of Bronchiolitis Obliterans Syndrome in Patients post Single and Double Lung Transplantation
• Funding: Chiltern Pharmaceuticals
• PI: Pali Shah, Jon Orens, Christian Merlo

EXPAND II

• International Trial to Evaluate the Safety and Effectiveness of the Portable Organ Care System (OCS™) Lung System for Recruiting, Preserving and Assessing Non-Ideal Donor Lungs for Transplantation
• Funding: Transmedics
• Investigators:Errol Bush( PI), Pali Shah, Jon Orens, Christian Merlo

Location

Clinic Address

Johns Hopkins Outpatient Center

Location: 7th Floor – Adult Medicine
601 N. Caroline Street, Baltimore, MD 21287

Mailing Address

Johns Hopkins Comprehensive Transplant Center

Location: Adult Lung Transplant Program Office
600 N. Wolfe Street, Halsted 665, Baltimore, MD 21287

Telephone Numbers

Administrative – (410) 614-4508
Clinic Appointment – (410) 614-4508
Nurse (8AM-4PM) – (410) 614-4508
Fax – (410) 614-7008
Page operator – (410) 955-6070

(ask for the pulmonary fellow on call)