One of the first lung transplant patients in the UK to receive a skin patch from his organ donor as part of a groundbreaking clinical trial believes the approach helped prevent his transplanted lungs from being rejected.
The SENTINEL trial is investigating whether transplanting a small patch of donor skin alongside a lung transplant can act as an early warning system for organ rejection, allowing treatment to begin sooner and reducing the risk of permanent lung damage.
The trial is funded through a partnership between the UK Research and Innovation Medical Research Council and the National Institute for Health and Care Research.
Lung rejection occurs when the recipient’s immune system attacks the transplanted organ, a major cause of illness and death following lung transplantation. Detecting rejection is particularly challenging and currently requires frequent hospital visits and invasive tests.
Rejection rates are highest in the first three to six months after a lung transplant, affecting up to 30 per cent of patients. Only half of lung transplant recipients are still alive five years post-transplant, with rejection being a significant contributing factor.
Researchers behind the SENTINEL trial hope the skin patch approach can make rejection easier to spot and treat earlier, improving long-term outcomes for patients.
In the SENTINEL trial, a small patch of skin from the organ donor is transplanted onto the recipient at the same time as the lung transplant.
The theory is that signs of rejection may appear on the skin patch first, in the form of a visible rash. This would provide a clear and early signal that the immune system is becoming active against the transplanted lungs.
If a rash develops, clinicians can take a small skin biopsy from the patch to confirm whether rejection is occurring, enabling prompt treatment and reducing the likelihood of lung damage.
Darren White, father to three-year-old Daniel, was one of the first patients in the UK to take part in the trial. Darren received his lung transplant in late 2024 after being diagnosed with lung fibrosis.
Three months after his transplant, Darren noticed a purple rash developing on the donor skin patch. He sent photographs to his transplant team, who asked him to attend his specialist centre for further investigation.
A skin biopsy confirmed mild rejection, which was treated promptly with steroids. Darren responded well to treatment and is now doing well following the intervention.
Darren believes the skin patch played a crucial role in identifying the problem early, allowing his medical team to intervene before serious lung damage occurred.
Researchers believe that if the SENTINEL trial proves successful, the approach could be rolled out to all lung transplant and heart-lung transplant recipients, potentially reducing rejection rates and improving survival.
Chief Investigator of the SENTINEL trial, Henk Giele, said:
“It seems logical that having a window to your transplant can provide an early warning system of rejection or reassure you that you don’t have rejection but we have to prove it works.
“We are so grateful to the patients, the donors and their families, the transplant teams, and the NHSBT staff who make this important trial happen. We hope it will change what we know about transplant and makes patients lives better and longer.”
By offering a simpler and more visible method of detecting rejection, the skin patch technique could also reduce the need for some invasive investigations and hospital visits.
The SENTINEL trial is scheduled to run until 2027 and aims to recruit a total of 152 patients. So far, 39 patients have been recruited and10 patients have received a donor skin patch.
Researchers will continue monitoring outcomes to assess whether the technique reliably detects rejection and improves long-term transplant success.
If successful, the trial could mark a significant advance in lung transplant medicine, offering patients a better chance of long-term survival and quality of life.
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