I am a transplant surgeon with a special interest in recurrence of disease after kidney or kidney-pancreas transplantation.
Along with Dr. Alberto Pugliese, we have been involved in studying recurrence of auto-immunity in those patients with type 1 diabetes (T1D) and end stage renal disease who underwent a kidney-pancreas transplant in the past. Our intention is to address the diagnosis and prediction of recurrent autoimmunity, a significant clinical problem, and to gain insight into the relationship between autoimmune humoral responses, cellular responses and disease progression in the transplanted allograft through biopsy. The pancreas transplant population provides a unique opportunity to conduct such studies, which are not feasible in TID patients who do not have a transplant. Our ultimate goal is to contribute to the possible treatment and cure of TlD through the application of therapy to T1DR.
Our other major interest is the treatment of children with focal segmental glomerulosclerosis (FSGS) and the problematic recurrence of proteinuria after kidney transplant. Our group initiated a protocol utilizing one dose of rituximab in addition to the standard induction immunosuppression protocol for pediatric patients with FSGS in order to mitigate against the recurrence of proteinuria after kidney transplantation. Serum was collected pre and post-transplant. Biopsies were performed pre and post reperfusion, looking for early changes consistent with podocyte foot process dysregulation. This led to our collaboration with Dr.Alessia Fornoni who demonstrated the favorable effect of rituximab clinically was associated with rituximab binding a novel target (SMPDL3B, a sphingomyelinase) on the podocyte membrane. This work has led to further work in which we used abatacept as rescue therapy for patients with recurrent proteinuria after kidney transplant for FSGS in the context of podocyte B7-l expression. Our collaborative work has the potential to shed light on the function of the podocyte, including its role in innate immunity, following transplantation, which may translate into the treatment of primary disease.
These two areas of research represent robust examples of "bedside to bench and back again'' translational research.
Professor Jeremy Chapman is a nephrologist, Past Director of Medicine and Cancer, Westmead Hospital and Western Renal Services, Chairman of the Australian Bone Marrow Donor Registry, Past President of The Transplantation Society, Deputy Chair of the WSLHD Board, Advisory Member of The WHO Expert Advisory Panel on Human Cell Tissue and Organ Transplantation, Secretary General and Past President of the WMDA and founding Co-Chair of the Declaration of Istanbul Custodian Group.
Professor Chapman remains actively involved in the academic field as Editor-in-Chief for Transplantation and Transplantation Direct 2015-2020. He has published over 430 publications and has a current lifetime H Index of 79. He is a Clinical Professor at the University of Sydney, Fellow of the Royal College of Physicians in the United Kingdom, Fellow of the Royal Australasian College of Physicians, and Fellow of the Australian Academy of Health and Medical Sciences
Professor Chapman’s clinical work has been in renal medicine, transplantation of kidney and pancreas and diabetic renal disease and islet transplantation.
Professor of Medicine, Vrije Universiteit Brussel
Bart Keymeulen, MD PhD, is a diabetologist and head of the research group Diabetes, Transplantation and Pathology. His main focus is translational research in the field of type 1 diabetes: diagnosis and immune intervention in the early stages and islet cell replacement therapy in patients with problematic hypoglycemia. This includes the use of stem cell-based cells in phase 1-2 human trials.