Yvonne Kelly, MD Awarded Jon Fryer Resident Scientist Scholarship by American Society of Transplant Surgeons
Yvonne Kelly, MD has been awarded the prestigious Jon Fryer Resident Scientist Scholarship by the American Society of Transplant Surgeons (ASTS) for 2019-2020. The award was presented at the 2019 American Transplant Congress earlier this month in Boston, Massachusetts. The scholarship is supported by the ASTS Foundation in order to foster innovation and research in the fields of transplantation and transplant immunobiology.
Dr. Kelly is a fourth year general surgery resident at UCSF currently in her first of two professional development years. She is completing her research fellowship in the UCSF Transplantation Research Lab, under the mentorship of Qizhi Tang, PhD and Peter Stock, MD, PhD.
The project supported by the grant will focus on understanding the immunogenicity of the parathyroid gland, which has recently emerged as a novel adjunct to enhance the engraftment and survival of pancreatic islet cell transplants. The Department of Surgery Chair, Julie Ann Sosa, MD, MA, FACS, described the research as "exploring the intersection between transplant and endocrine surgery, the next frontier!"
Dr. Kelly was also the recipient of the "Poster of Distinction" Award at the conference for her innovative research.
Project Summary
Over the last decade, there has been increased use of pancreatic islet transplantation to restore normoglycemia in patients with Type 1 diabetes. However widespread application has been limited by several barriers, particularly the sensitivity of islets to ischemia. Conversely, another highly vascularized endocrine tissue, the parathyroid gland, engrafts at very high success rates (>90%) in thousands of patients every year in the intramuscular site, a site considered to be too harsh for islets given its lack of vascularity. The success in parathyroid autotransplantation has been attributed to an unusually high percentage (3-5%) of CD45-CD34+ vascular endothelial progenitor cells resident in these glands. Over the last year and a half, our lab has been exploring the novel idea of parathyroid and islet co-transplantation with both human islets and stem-cell derived insulin producing cells (SCIPCs) in the intramuscular and subcutaneous sites in preclinical mouse models of diabetes. We have seen statistically significant improvement in islet engraftment and function and unprecedented reversal of diabetes and restoration of normoglycemia. As the possibility of islet and parathyroid composite transplants moves from bench to bedside, it will be important to understand how the parathyroid is supporting and protecting the islet cells. There are sparse published data suggesting the parathyroid has little to no MHC expression and can remain functional in an allotransplant setting for several months without immunosuppression. This study aims to further our knowledge of the interaction between the parathyroid and the immune system, a relationship which could prove key to islet protection and survival.