SENTINEL study investigating if a skin flap in lung transplant can help to detect signs of transplant rejection earlier than other methods

Upcoming study
Expected to open March 2023
This study is currently recruiting
Expected to close September 2028
This study is closed
This study closed in September 2028
We will update this page with study results when available.
Information on study results are included below
This study closed in September 2028
Ask your healthcare team about taking part in research

What next?

Original listing:

What next?

Original listing:

About this study

Some people with pulmonary fibrosis receive a lung transplant. With any transplanted organs, including the lungs, there is a risk of rejection. If this occurs and is not treated, the transplanted organ can become damaged and will stop functioning. It is difficult to know if lung transplant rejection is happening, and people who receive a transplant need frequent tests to detect this.

The SENTINEL study aims to find out if a small patch of skin transplanted at the same time as the lung, from the same donor, can help to detect signs of transplant rejection earlier. This is called a sentinel skin flap. The skin is transplanted to the lower arm and may act as a way to visually check for potential rejection, showing a red rash. Currently, for lung transplants the only way to determine rejection is by doing a biopsy of the lung. It may also help to protect the lung transplant itself from rejection damage.


What is involved?

Only patients already registered for lung transplant can be considered to take part in this study.

You will be randomly assigned to one of two groups.

  • Group 1 will receive the lung transplant and the skin flap transplantation
  • Group 2 will receive just the lung transplant

If you are in group 1, a skin flap transplantation measuring 10 x 3 cm will be placed on the underside of your forearm. Before you are discharged from hospital, you will be taught what skin changes to look out for. When you visit the hospital for routine follow-up appointments and tests, at 3, 6 and 12 months, you will have skin biopsies taken from the skin flap. In between those times, if you notice a rash or symptoms that there may be lung rejection, you will attend the hospital to undergo investigations.

If you are in group 2, and only receive the lung transplant, you will not have skin biopsies taken, but you will have tests, such as blood tests at your routine hospital visits at 3, 6, and 12 months.

Everyone taking part in the study will have the contact details for the transplant and research study team, if you have any questions or concerns.

More information can be found on the SENTINEL study website.

Summary of involvement

Either receive a lung transplant and sentinel skin flap, or just a lung transplant

Medical tests at routine post-transplant appointments at 3, 6 and 12 months


Can I take part?

You may be able to take part in the study if you are on the lung transplant list and a suitable lung becomes available.

In research studies, there are lots of different reasons why you may or may not be able to take part. These are known as inclusion and exclusion criteria (see list below). Only the research team will be able to fully determine whether you are able to take part in the study. You can withdraw at any point.

If you are not able to take part in this research study, there may be other opportunities for you to take part in different studies.

To find our more about other research opportunities visit our research finder main page.

You may be able to join this study if all of these apply:

Recipient of a lung transplant

Aged 18 years and over

You will not be able to join the study of any of the following applies:

Not registered for lung transplantation at one of the five study locations.

What difference could taking part make?

Taking part in this study may help researchers to understand if using a sentinel skin flap helps to detect or prevent rejection of lung transplantation.

Where does the study take place?

Study locations






How to take part

If you are on the waiting list for a lung transplant at one of the five study locations, you may be invited to take part in the study. You can also speak to your healthcare team to express your interest in taking part in research.

You can find out more information by visiting the SENTINEL study website or by emailing

Further information

This page is a summary which provides information about an opportunity to participate in research. More detailed information about the study can be found via the following the links and through contacting the research team.

If you have any questions about this research study, please speak to your medical team.

This study is supported by

National Institute for Health and Care Research (NIHR)
Study ID number:

APF does not endorse or recommend any specific study. All responsibility for the study remains with the sponsors and investigators.

Every effort is made to keep these details up to date. If you are aware of any inaccuracies, please email