Staying a step ahead of infections that threaten safe transfusion and transplantation
Inaugural lecture image: Unsplash
Preventing viral infections from being transmitted through blood transfusion and organ transplantation lies at the heart of the work of medical microbiologist and virologist Mariet Feltkamp and her team. By combining screening, research and a forward-looking approach, they protect the safety of blood and transplants.
What does your professorship involve?
‘I am Endowed Professor of Medical Microbiology with a focus on preventing the transmission of viral infections through blood transfusion and organ transplantation. My chair spans two fields and two institutions: the LUMC and Sanquin Blood. In practice, this often means selecting and testing donors for specific viruses. It also involves what I describe as strengthening the recipient’s resilience.’
What is the main message of your inaugural lecture?
‘There are several main messages. First, donor screening must match the infection landscape – the infections that may be present in a particular region. That landscape is constantly changing. Some infections are on the rise, for example as a result of climate change, including mosquito-borne diseases such as dengue and West Nile fever. Others are becoming less relevant thanks to effective treatment and falling numbers, as we see with hepatitis C. We need to anticipate these trends to maintain the safety of blood and organ donation, and to ensure that screening programmes remain efficient.
‘We are also working to close knowledge gaps that still exist in certain areas. These gaps can stand in the way of effective donor screening. To close them, we contribute to research on the presence of new infections in the Netherlands. In addition, we aim to better understand why some organ donors pose a higher risk of transmitting a virus than others, even when they are infected with the same virus. A good example is the BK virus, which causes inflammation in transplanted kidneys.
‘A promising new blood marker, TTV (which is itself a virus), also deserves a place in transplantation care. It doesn’t cause symptoms but essentially rides on its host’s immunity. It can be measured using a simple PCR test. Monitoring TTV levels could help doctors tailor immunosuppressive medication for transplant patients, potentially reducing complications such as rejection and infection.’
What are the main research themes you and your team are working on?
‘At the LUMC, my main focus is on the BK virus and TTV. At Sanquin, the emphasis is on emerging mosquito-borne infections and how we can prepare for them. I also study parvovirus, which can cause severe anaemia, especially in unborn babies. These babies need a transfusion while still in the womb. In the Netherlands, this care is provided at the LUMC, the national centre of expertise in this field. In 2024, there was a major parvovirus outbreak, and we are now investigating what caused it.’
Is there a moment from recent years that has stayed with you?
‘Without question, the Covid-19 pandemic. It was an extraordinary time for us as virologists. Although the workload was immense, it gave me a lot of energy. Another memorable moment was the discovery of a virus known as the TS polyomavirus. A heart transplant patient’s facial hair had turned into stiff bristles. We were able to find the cause and start the right treatment, causing the bristles to disappear completely.
‘What made this even more special was the fact that a Nobel Prize winner had drawn attention to this mysterious clinical phenomenon in his Nobel lecture the year before. It was also a rare example of completing the entire bedside to bench and back again cycle: from clinical observation, to diagnosis, to diagnostic testing and effective treatment. This is a research concept that is often described in project proposals, but that rarely succeeds in practice.’
What impact might patients and society notice from your work?
‘That’s a tricky one. I aim to ensure that transfusions remain safe, even as new blood-borne infections emerge. And I hope that the introduction of TTV monitoring will mean that transplant patients experience fewer side effects from the immunosuppressive drugs they rely on. If this also makes transplantation care that bit more cost-effective, that would be a welcome bonus.’
Looking ahead, where do you hope the field will be in 10 to 15 years?
‘I expect that by using both AI and good old common sense, we will be much better at identifying new infections that threaten safe transfusion and transplantation. I am thinking in particular of mosquito-borne infections such as dengue and West Nile fever, which are likely to become more common in the Netherlands as a result of climate change.
‘We should be better at predicting where these will occur, allowing targeted donor screening to be used exactly where it is needed.
Mariet Feltkamp’s inaugural lecture ‘Geven en nemen’ (Give and Take) will be streamed live on the Leiden University website.