Medical Research Project

Successful heart transplants in children

Analysing samples from children who have received a new therapy following a heart transplant, to identify a pattern within the immune system that can predict for the long-term success of the surgery.

In progress
19/11/2025
Heart failure
London

Target validation

Awarded amount: £224,405
Grant scheme: TRP
Institution: Great Ormond Street Hospital for Children NHS Foundation Trust
Principle Investigator: Professor Michael Burch

Each year in the UK, around 30 children undergo a heart transplant, with around half taking place at Great Ormond Street Hospital (GOSH). Heart transplantation is only performed as a last resort when a child’s heart has become too weak to pump blood around the body due to disease or structural issues, and all other treatment options have stopped working.

While there have been major advancements in transplantation care, unfortunately for a lot of children, a new heart won’t last them a lifetime. One of the main conditions that affects the long-term survival of a transplanted heart is cardiac allograft vasculopathy (CAV), which results in the gradual narrowing of the blood vessels supplying the heart, restricting blood flow and heart function. It is caused by the body’s own immune system attacking the new heart, and so current treatment options are aimed at weakening the immune system using medications or performing another transplant – both of which bring risks of serious side-effects and complications.

However, Professor Michael Burch and his team at GOSH are trialling a new treatment option for children who have had a transplant, to improve their long-term outcomes. This involves making use of the body’s own immune system “peacekeepers”, known as regulatory T cells (Tregs) which counteract the other immune cells causing harm to the transplanted heart. These Tregs are taken from the patient, reproduced in larger numbers in a lab, then delivered back to the patient to protect their heart in a personalised way.

To test this therapy, children who have undergone heart transplantation at GOSH will either receive standard treatment, or Treg therapy along with standard treatment, then be monitored for two years afterwards. They will also take genetic samples which will be analysed to see how Treg therapy alters the immune system’s response and also identify potential immune ‘signatures’ – patterns of cells and signals, that can predict whether a transplantation will be successful in the long term.

This research has the potential to improve the long-term health of children living with heart transplants by protecting against their own immune system attacking their new heart. It also may benefit the wider transplant community by identifying immune signatures that can predict long-term outcomes of organ transplants.

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