Researchers Investigate Biomarkers to Improve Lung Transplant Survival Rates
A research team at the Hannover Medical School (MHH) is launching a new study to identify liquid biomarkers that predict long-term survival in lung transplant recipients. By analyzing plasma proteomics and immune cell activity, the project aims to reduce the incidence of chronic lung allograft dysfunction (CLAD)—the leading cause of long-term mortality—by enabling earlier, personalized clinical interventions. The study, supported by the state of Lower Saxony and the Volkswagen Foundation with approximately 465,000 euros, focuses on why some patients achieve long-term transplant tolerance while others experience chronic rejection.
Why Do Lung Transplant Outcomes Vary?
Despite significant advancements in surgical techniques, lung transplantation remains a complex procedure with varied long-term outcomes. According to the Hannover Medical School (MHH), approximately half of all transplant recipients succumb to complications within six to ten years post-surgery. The primary driver of this mortality is CLAD, or chronic rejection, where the transplanted organ gradually loses function. PD Dr. Lavinia Neubert, a pathologist and lead researcher at the MHH, notes that while survival times have improved, the high rate of long-term failure remains a critical challenge for transplant medicine.
The Role of Alveolar Macrophages in Transplant Tolerance
The research team is investigating “super-survivors”—patients who show no signs of transplant dysfunction at least three years post-operation. Preliminary research by Edith Schwarz, a doctoral candidate at the MHH Institute of Pathology, identified a high density of alveolar macrophages within the lungs of these patients. Macrophages are immune cells that can act as either protective agents or drivers of inflammatory responses. PD Dr. Jan-Christopher Kamp, co-lead of the project, explains that the team is now working to determine the precise conditions that trigger these cells to adopt a protective versus an inflammatory phenotype. Identifying these molecular “switches” could allow clinicians to modulate the immune environment of the graft to favor long-term acceptance.
How Minimal-Invasive Blood Tests Could Transform Monitoring
To move beyond invasive tissue biopsies, the MHH team is developing methods to track transplant health through blood plasma analysis. Using mass spectrometry—conducted at the MHH Core Facility Proteomics—researchers aim to map the protein profiles of patients at specific time points after surgery. By comparing these plasma samples with cells collected via bronchoalveolar lavage, the researchers hope to define a biomarker signature for early detection of rejection. This approach seeks to provide a minimally invasive, longitudinal monitoring tool that allows physicians to intervene before irreversible damage occurs.
Project Scope and Institutional Collaboration
The research initiative, titled “Identifying liquid biomarkers for the prediction of clinical outcomes after lung transplantation using plasma proteomics,” is a multi-disciplinary effort. The project integrates expertise from several MHH departments, including:
- Institute of Pathology
- Institute of Transplantation Immunology
- Department of Pneumology and Infectious Disease
- Hannover Unified Biobank (HUB)
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM)
The study, which began in June 2026, is funded under the “zukunft.niedersachsen” program, which specifically targets the development of new diagnostics for rare and complex diseases. By bridging the gap between basic immunology and clinical diagnostics, the team expects to develop a new framework for managing transplant health that could eventually be integrated into standard post-operative care protocols.