The VISICORT project: Lessons learned from solid organ transplantation

Aims of the Presentation: (a) To summarize the rationale and research strategies for the VISICORT project. (b) To compare and contrast research approaches to understanding adverse immune responses to corneal and solid organ allo‐transplants. Corneal allo‐transplantation has been utilized for over 100 years to restore and improve vision in patients suffering from opacifying diseases of the cornea. Its development preceded that of solid organ transplantation and its worldwide frequency continues to exceed that of commonly‐transplanted organs including kidney, heart, liver and lung. The scope and success rates for corneal transplantation have evolved over time as a result of technical innovations, clinical practice developments and advances in eye banking. However, the impact of immunological complications, in particular acute rejection, on the long‐term functional survival of high‐risk corneal allografts has remained significant and the evidence base for specific immunosuppressive regimens to prevent rejection is limited. Strikingly, the large amount of elegant pre‐clinical research into the immunological response to corneal allografts has not been complemented by extensive studies of adverse immune responses in human recipients. Against this background, the VISICORT project was initiated in 2014 to bring together corneal transplant experts and investigators with expertise in solid organ transplantation, immunological profiling, proteomic analysis, regenerative therapies and biobanking to collaboratively address the challenge of better understanding adverse immune responses in human corneal transplantation. In this presentation, I will first summarize the strategies and designs for cross‐sectional and longitudinal clinical cohort studies of corneal allo‐transplant recipients at 5 European academic centres with collection of extensive clinical data and biological specimens including donor and recipient cornea, aqueous humour, tears, whole blood, serum, plasma and peripheral blood mononuclear cells. I will also describe the development of bespoke resources and protocols for the coordination of patient enrolment, data gathering and biospecimen processing, storage and transfer to a central biobank which underpinned the results to be described by other presenters in this session. Finally, I will discuss the extent to which the fields of corneal and solid organ transplantation have engaged in collaborative investigation prior to and during the course of the VISICO