Multidisciplinary team secures multimillion-dollar award to fund research to achieve a functional human eye transplant

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The Advanced Research Projects Agency for Health (ARPA-H) announced the teams to receive awards from its Transplantation of Human Eye Allografts (THEA) program.

The agency’s commitment is up to $125 million, for a series of groundbreaking investments to develop the first-ever complete eye transplantation procedure and restore vision for the blind and visually impaired.

“What if we could cure blindness? Modern medicine can correct some eye problems, but we really have no way to restore lost vision, which THEA now seeks to change,” said ARPA-H Director Renee Wergrzyn, PhD. “THEA intends to revolutionize the reconnection of nerves to the brain and develop breakthroughs in transplantation, preservation, and neuroscience. ARPA-H’s investment has the potential to repair vision loss for millions of Americans.”

Teams are led by:

• InGel Therapeutics in Allston, Mass. (TA 2), focusing on 3-D printed click-lock gel technology with micro-tunneled scaffolds containing stem cell-derived retinal cells.
• Stanford University (TAs 1, 2, and 3), focusing on donor eye procurement, developing new strategies to promote survival and regeneration of the transplanted cells, and performing transplant surgeries.
• The University of Colorado Anschutz Medical Campus (TAs 2 and 3), focusing on developing novel stem cell and bioelectronic technologies to promote nerve regeneration and performing transplant surgeries.
• The University of Miami Bascom Palmer Eye Institute (TA 1), focusing on donor eye procurement and preservation outside the body with its eye-ECMO device.

Researchers at the Bascom Palmer Eye Institute and the University of Miami Miller School of Medicine hope to use the award for a groundbreaking “moonshot” project.

According to a news release from the Bascom Palmer Eye Institute and the University of Miami Miller School of Medicine, the award (1AY1AX000038-01) will support the Transplantation of Human Eye Allografts (THEA) program, which aims to achieve full human eye transplantation.¹

Daniel Pelaez, PhD, associate professor of ophthalmology and co-principal investigator, Bascom Palmer is leading efforts to develop a surgical approach for whole eye transplantation and optic nerve regeneration. This research represents a significant advancement in the field of vision restoration.

Joining Pelaez as a co-principal investigator is David T. Tse, MD, an expert in oculoplastic surgery and orbital disease. Together, they have assembled a multidisciplinary team to address the complex challenge of surgically recovering a live human eye and preserving its function for vision restoration through organ transplantation. This step is critical for the success of a complete, functional 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,” Pelaez said in a statement. “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,” Tse added in the statement.

Eduardo C. Alfonso, MD, director and chair of Bascom Palmer, lauded the project.

“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," he said in the statement.

Tse noted that 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,” Tse said. “The audacious idea of a whole eye transplant stimulates the senses, stirs emotions, and fuels the imagination of the scientific community.”

For more than a century, physicians have successfully transplanted the cornea 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, Pelaez explained that 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 transplantation procedure is critical for the survival of the transplanted ocular tissue and for ensuring functional vision. A multidisciplinary team of experts in ophthalmology, surgical transplantation, neuroscience, microbiology, immunology, plastic surgery, computational science, and biomedical engineering is collaborating on this innovative project.¹

Bascom Palmer's team includes Felipe Medeiros, MD, PhD, a professor of ophthalmology and vice chair of research, who will provide expertise in data science and bioinformatics. Jean-Marie Parel, ETS-G, PhD, the director of the Ophthalmic Biophysics Center, is also part of the team. Parel has developed over 350 surgical instruments and clinical devices that have advanced clinical optic care globally. Jianhua (Jay) Wang, MD, PhD, an electrical and computer engineer, has created a range of imaging modalities to study structural and functional changes in the eyes.¹

According to the news release, Victor Perez, MD, an expert in ocular immunology, will assess the immune response to eye transplantation and develop immunomodulatory strategies to improve the procedure's success. Vittorio Porciatti, DSc, Bascom Palmer's director of research, brings his expertise as a neuroscientist, retinal electrophysiologist, and biomedical engineer.

University of Miami collaborators on the project include Carolina Benjamin, MD, a neurosurgeon with expertise in microsurgical anatomical dissections of the skull base. She worked with Tse to refine the novel surgical approach to eye transplantation. Ashutosh Agarwal, PhD, a biomedical engineer, is collaborating with Parel and Porciatti to develop an eye organ life-support system (eye-ECMO) to keep the donor eye alive and functional. Robert Levy, PhD, a professor of microbiology and immunology, is working alongside Dr. Perez to explore the immunological aspects of the project.¹

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 organ transplantation teams and facilities to establish standardized 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 required for organ transplants. Lastly, plastic surgeons Kyle Y. Xu, PhD, and Devinder Singh, MD, are experts in microsurgery, particularly microvascular reconstruction.

Earlier this year, philanthropist and humanitarian Lois Pope provided a $1 million donation to the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, doctors and researchers are fast-forwarding their high-impact initiative to transplant the whole eye.²

“My mother suffered terribly for many years from macular degeneration,” Mrs. Pope said in a statement on March 5, 2024. “Of course, she is not alone. There are 20 million people here in the U.S. with that disease. And when you combine that with the millions facing blindness and vision impairment from many other conditions, you can quickly understand how essential it is for this project to come to fruition. If my gift to Bascom Palmer can in a small way make that happen more quickly, then I will have done what I’ve always set out to do with all my philanthropic work, which is to help transform lives of the most vulnerable members of our society.”

References

1. Writer S. Bascom Palmer Receives Multimillion Dollar Award to Support Functional Whole-Eye Transplant - InventUM. InventUM. Published December 2, 2024. Accessed December 3, 2024. https://news.med.miami.edu/bascom-palmer-receives-multimillion-dollar-award-to-support-whole-eye-transplant/

2. Writer S. Bascom Palmer Eye Institute’s “Moon Shot” Whole Eye Transplant Research Initiative. InventUM. Published March 5, 2024. https://news.med.miami.edu/bascom-palmer-focuses-on-whole-eye-transplants/