The major research goals of Mark D. Stegall, M.D., are to:
- Improve the long-term outcomes of kidney transplant recipients
- Develop new therapies to block the body from forming antibodies against the transplanted kidney
Dr. Stegall's research applies to all patients with kidney disease, including those with diabetes, polycystic kidney disease and high blood pressure.
His basic science studies might also apply to patients with diseases of the immune system, including autoimmune disorders such as lupus. These studies apply to children and adults of all ethnic groups, but especially those with high rates of kidney disease, such as African-Americans and Native Americans.
- Late loss of kidney transplants. Kidney transplantation has become extremely successful over the past decade. However, the long-term survival of kidney transplants — five years and beyond — has not improved. Dr. Stegall's group has led the way in improving the understanding of late kidney transplant loss.
Using sensitive genomic techniques, Dr. Stegall's laboratory has shown that many transplanted kidneys have evidence of rejection that is not seen by conventional microscopic techniques. He and his team now believe that they can predict which kidney transplants are likely to fail, and they are developing clinical trials to determine if changes in immunosuppression can prevent failure.
- Antibody barriers to kidney transplantation. Many renal transplant candidates — approximately 1 in 3 — have antibodies in their bloodstream that react against kidney transplants. These antibodies can severely damage or even destroy a kidney transplant.
Dr. Stegall's laboratory tries to understand how these antibodies are made and has developed novel and sophisticated methods of testing the actual cells that make antibody in humans. They also have developed several new agents that prevent the antibody formation and antibody damage.
Significance to patient care
The research of Dr. Stegall and his colleagues is significant because their two areas of focus are two of the major unsolved problems in transplantation.
Improving long-term kidney graft survival would mean that patients would be less likely to need a second transplant during their lifetime and would lead healthier lives.
Overcoming antibody barriers to transplantation would mean that successful kidney transplants could be provided to more people who need them. Today, many patients with antibodies never receive a transplant because they can never find a kidney against which they have no antibodies. Their lives are shortened because they remain on dialysis, and they have a very poor quality of life.
Dr. Stegall's hope is that every patient with kidney disease who requires a transplant will be able to receive a successful transplant that will last his or her entire life.
- Paul I. Terasaki Clinical Science Award (for research in antibody barriers to transplantation), American Society for Histocompatibility and Immunogenetics, 2011
- Novel Methodology Development Award (for genomics research), Mayo Clinic, 2011
- Member, Editorial Board, American Journal of Transplantation
- Member, Editorial Board, Transplantation