PEPR TREASURE
Scientific challenges
TREASURE has identified a series of major scientific challenges that the programme aims to address. Here is an overview, grouped by domain.
- 1
Mechanisms of immune tolerance and rejection
The mechanisms of tolerance (acceptance of the organ) and of rejection remain only partly understood, which hampers targeted therapies that could induce tolerance while avoiding lifelong immunosuppression.
TREASURE response In-depth immunology, advanced transplantation models and high-throughput screening to identify new therapeutic targets.
- 2
Non-invasive biomarkers for patient monitoring
There is a lack of validated non-invasive biomarkers to detect rejection and complications early; care still relies on invasive biopsies.
TREASURE response Advanced molecular and genetic tools together with large-scale, multi-institution longitudinal studies.
- 3
Chronic rejection and long-term graft survival
Chronic rejection, still poorly understood, remains a leading cause of long-term graft loss.
TREASURE response Long-term studies, advanced imaging and immune profiling of patients over time.
- 4
Individualised immunosuppression
Patient responses to immunosuppressive drugs vary widely, making their management complex.
TREASURE response Predictive models and robust databases of patient responses, towards personalised medicine.
- 5
Procurement logistics and ischaemia-reperfusion injury
Ischaemia-reperfusion injury, occurring when the organ is revascularised, can degrade transplant outcomes.
TREASURE response Optimise organ-retrieval logistics and perfusion machines, and improve donor/recipient anatomical matching.
- 6
Functional bio-artificial organs and tissues
Engineering augmented organs and tissues is still in its early stages, yet could relieve the organ shortage.
TREASURE response Cutting-edge bioprinting, innovative materials and robust cell-differentiation protocols.
- 7
Complications of immunosuppression
Transplant recipients are vulnerable to infections, cancers, cardiovascular events and metabolic disorders induced by immunosuppression.
TREASURE response Understand the interactions between treatment, immune system and pathogens, and cooperate with other programmes to control these risks.
- 8
Integrating advanced technologies (AI, digital)
Integrating AI, machine learning and digital health tools remains complex to adopt in practice, despite their potential.
TREASURE response Build on reference work, including the “adoption” dimension.
- 9
Robust clinical trials in transplantation
Designing and running robust trials is difficult (patient variability, ethical issues, duration).
TREASURE response Accelerate enrolment, use digital twins and predictive algorithms, and foster close collaboration between researchers, regulators and patient associations.
- 10
Sociological, ethical and economic limits
Existing analyses need to be deepened to inform public decisions (pricing, care pathways, value of services).
TREASURE response Closely involve patient associations in setting priorities.