For more than 20 years, Rita Alloway, PharmD, and E. Steve Woodle, MD, have led the UC College of Medicine transplant research team to improve outcomes for transplant patients in the region and across the country. In addition to Alloway, Director of Transplant Clinical Research and Research Professor of Internal Medicine in the Division of Nephrology and Hypertension, and Woodle, William A. Altemeier Chair in Surgery, Professor of Surgery, and Director of Solid Organ Transplantation at UC Health, the highly accomplished, multidisciplinary team includes other pharmacists and surgeons, nephrologists, hematologists, pathologists, immuno-biologists and many other dedicated researchers.
“The transplant clinical research program is very much a team effort that involves a lot of people coordinating logistics to implement studies that not only impact patient care today, but impact patient care in the future,” said Alloway. “We design innovative, novel, immunosuppressive regimens for transplant patients that hopefully give them longer graft survival with fewer adverse effects.”
As leaders of the transplant research team, Alloway and Woodle are responsible for building and expanding both clinical and basic research programs. While a majority of their research is clinical, building the basic research and translational research components have been critical to improving patient outcomes.
“Those efforts have resulted in recent NIH funding awards focused on both types of rejection, the antibody and the cellular,” said Woodle. “We're bringing to bear really cutting-edge technologies that are extraordinarily powerful, and we hope that it's going to significantly enhance our understanding of the biology that underlies rejection and lead to new therapies.”
For example, Alloway, Woodle and their team pioneered research related to steroid withdrawal in transplant patients showing that there’s no short- or longer-term benefit to taking steroids, whereas removing them from patients’ treatment regimen leads to fewer side effects. Previously, morbidities associated with steroids were one of the major complications related to transplants. Now, more than half of the kidney transplants performed in the U.S. are without steroids.
But that’s not all. Alloway and Woodle’s list of contributions to transplant care is extensive, especially related to anti-rejection. Their team has established the use of new drugs, pioneered kidney exchange programs and developed new strategic approaches towards treatment. They’ve identified bad forms of rejection that cause patients to lose their kidneys and they’ve developed totally new directions to address those antibody-mediated rejections.
“And now we're taking it even a step further, where we're going back and starting to understand the biology that underlies all rejection,” said Woodle. “I think we can look back and understand that these were significant contributions.”
According to Alloway and Woodle, transplantation is the ultimate team sport. The more the transplant research team expands to include various disciplines, the better their patients do. Each team member brings a unique area of expertise. And those who come to train with the transplant research team benefit from mentors of various backgrounds, whether they’re transplant surgeons, pharmacists, nephrologists, hematologists or pathologists.
“There's nothing more rewarding to me than being a mentor,” said Alloway. “I have strong personal and professional relationships with the people that I've trained, but what’s rewarding is looking out across all of the premier transplant centers and seeing transplant pharmacists that we've trained here.”
Having pharmacists like Alloway integrated into the clinical transplant research team, and training new pharmacists in this unique environment, has allowed the team to approach issues related to transplantation differently.
“We hope that our work has allowed our transplant patients to have novel, cutting edge therapies with less toxicities sooner than most of the transplant population,” said Alloway. “Much of our research is really impacting our community locally, but in the future, we hope it will have further national and even global implications for transplant patients.”