The Bascom Palmer Eye Institute and University of Miami Miller School of Medicine researchers have received a multimillion moonshot project award (1AY1AX000038-01) from the U.S. Department of Health and Human Services’ Advanced Research Projects Agency for Health (ARPA-H) for the Transplantation of Human Eye Allografts (THEA) program, with the aim of transplanting the entire human eye.
“Bascom Palmer is leading a groundbreaking surgical approach to whole human eye transplantation and optic nerve regeneration, marking an exciting advancement in vision restoration,” says Daniel Pelaez, PhD, associate professor of ophthalmology and a co-principal investigator of the award.
Joining Pelaez as a co-principal investigator is David T. Tse, MD, an oculoplastic surgery and orbital disease expert. Together, they have assembled a multidisciplinary team to tackle the formidable task of surgically recovering a live human eye and maintaining its function for vision restoration through organ transplantation, a pivotal step for the success of a complete and seeing eye transplant.
"This program represents the true power of collaborative science, bringing together experts across disciplines to confront one of the most complex challenges in modern medicine,” said Pelaez. “By leveraging cutting-edge innovation in transplantation, bioengineering, and neuroscience, we are pushing the boundaries of what’s possible, with the potential to revolutionize vision restoration and transform lives."
“The award to the University of Miami consortium of multidisciplinary investigators is to develop a workflow to recover a donor's eye, a method to preserve the eye, and a technique for evaluating the viability of retinal tissue for transplantation,” says Tse.
“This groundbreaking project holds the promise of yielding novel therapies for debilitating eye conditions such as glaucoma and diabetic retinopathy, as well as potentially unlocking a transformative breakthrough that brings hope to patients grappling with spinal cord injuries and other nerve-related afflictions," said Eduardo C. Alfonso, MD, director and chair of Bascom Palmer.
"The greatness in medicine is not about the possible but the impossible. This once unthinkable challenge to overcome the biological barriers to optic nerve regeneration to regain vision is our shot at the moon. The audacious idea of a whole eye transplant stimulates the senses, stirs emotions, and fuels the imagination of the scientific community,” said Tse.
For over 100 years, doctors have successfully transplanted the cornea, the clear tissue at the front of the eye, to treat specific types of vision loss. However, the transplantation of the entire eye, including the eyeball, blood supply, and the optic nerve that connects it to the brain, is considered a significant challenge in the effort to cure blindness.
“This is an extremely complex procedure, and we have assembled a diverse team of physicians and scientists to solve it,” said Pelaez. “Optic nerve regeneration and reconnection are far from the only daunting challenges to overcome for a successful whole-eye transplant. On the surgical side, the donor eye tissues must be removed and transported to the recipient in a life support system that preserves the eye. Then microsurgery and oculoplastic procedures are needed to place the eye in the right position, reattach the muscles and blood vessels, and reconnect the optic nerve,” he added. Maintaining blood flow to the eye throughout the procedure is essential for the survival of the transplanted ocular tissue and functional sight. Experts in ophthalmology, surgical transplantation, neuroscience, microbiology and immunology, plastic surgery, computational science, and biomedical engineering are working together on the project.
Bascom Palmer’s physicians and scientists include Felipe Medeiros, MD, PhD, a professor of ophthalmology and vice chair of research. He will provide expertise in data science and bioinformatics.
Also on the team is Jean-Marie Parel, ETS-G, PhD, the director of the ophthalmic biophysics center, who has created more than 350 surgical instruments and clinical devices that have enhanced clinical optic care worldwide.
Jianhua (Jay) Wang, MD, PhD, an electrical and computer engineer, has developed a wide range of imaging modalities that study structural and functional alterations in the eyes.
Additionally, Victor Perez, M.D., an expert in ocular immunology, will evaluate the immune response to eye transplantation and devise immunomodulatory strategies for the success of the procedure. Vittorio Porciatti, D.Sc, Bascom Palmer’s director of research, will bring his expertise as a neuroscientist, retinal electrophysiologist, and biomedical engineer.
University of Miami collaborators on the project include Carolina Benjamin, MD, a neurosurgeon expert in microsurgical anatomical dissections within the skull base who worked with Tse on the refinement of the novel surgical approach to eye transplantation; Ashutosh Agarwal, PhD, a biomedical engineer working in collaboration with Parel and Porciatti on an eye organ life-support system (eye-ECMO™) to maintain the donor eye alive and functional; and Robert Levy, PhD, a microbiology and immunology professor working alongside Perez on the immunological aspects of the project.
Clifton McClenney and Louay Hatem, MD, the senior director of operations and medical director of the Life Alliance Organ Recovery program, respectively, will coordinate with other organ transplantation teams and facilities to develop harmonized guidelines for the successful recovery of human donor eyes. Alfred Tector, MD, and Rodrigo Vianna, MD, PhD, from the Miami Transplant Institute, are specialists in the technical modifications necessary for organ transplantations. Finally, plastic surgeons Kyle Y. Xu, MD, and Devinder Singh, MD, are experts in microsurgery, specifically microvascular reconstruction.
To learn more about the vision research taking place at the Bascom Palmer Eye Institute, visit www.bascompalmer.org