Solid organ transplantation is a cornerstone of care for end-stage organ disease and a critical consideration for all doctors managing chronic conditions such as chronic kidney disease. Transplantation is wholly dependent on organ donation (both living and deceased), with shortages directly limiting access to life-saving therapy and resulting in preventable mortality for patients on waiting lists. Yet undergraduate exposure to organ donation and transplantation (ODT) across UK medical schools is anecdotally poor and not mapped nationally. The most substantive UK evidence is more than two decades old and demonstrates limited exposure and significant knowledge gaps among final-year medical students.

We here describe a protocol for two coordinated national surveys: U-KNOW-RT (Understanding and Knowledge of Renal Transplantation; final-year students) and U-TEACH-ODT (Undergraduate Teaching in ODT; educator leads). Together, these will provide the first UK-wide mapping of undergraduate ODT education, generating contemporary evidence on teaching provision, student exposure, knowledge, attitudes and career intentions. This work will directly inform the design of a standardised national ODT teaching module to ensure that all UK medical graduates attain a core level of literacy in ODT. Survey distribution is scheduled for January 2026, with completion expected by summer 2026.

We will conduct two parallel cross-sectional online surveys. U-KNOW-RT will recruit final-year medical students from all 44 UK medical schools via social media, institutional channels and student societies. U-TEACH-ODT will invite deans and senior curriculum leads. The student target is ~1200 responses (≥10 per school) to enable national mapping and triangulation with educator reports. Analyses will follow the Consensus-Based Checklist for Reporting of Survey Studies and the Checklist for Reporting Results of Internet E-Surveys reporting frameworks. Prespecified outcomes include student knowledge, exposure and attitudes alongside educator-reported curricular provision. Primary analyses will use mixed-effects regression with school-level clustering, agreement between student and educator reports will be quantified and selected items will be readministered to allow 20-year comparisons with legacy surveys.

This study involves human participants and was granted ethical approval by the University of Sheffield Ethics Department (reference 070914) on 25 November 2025. Participants provided informed consent before taking part. This manuscript reports a study protocol only; no results will be reported. Findings will be disseminated through peer-reviewed publications, conferences and feedback to medical schools and national bodies. De-identified data, questionnaires and analysis code will be shared openly on Open science framework.

OSF preregistration (DOI 10.17605/OSF.IO/38W5N).

Approximately 6%–10% of adults carry food allergy labels. Many such labels are unverified and may be incorrect, contributing to delays in appropriate care, significant dietary restriction, anxiety and unnecessary use of emergency medications. Oral food challenges (OFCs) are the gold standard for confirming or excluding food allergy, but the current model of clinic-based challenges often has long wait times and logistical barriers. This study aims to investigate the feasibility and safety of home-based OFCs compared with standard in-clinic challenges in adults with negative skin-prick testing.

Food Challenge at HOme or in Medical Practice is a pilot multicentre randomised controlled trial enrolling 120 adults with reported food allergy labels and negative skin prick testing to the implicated food. Participants will be randomised 1:1 to undergo an OFC either at home or in-clinic. The study is designed to generate feasibility and preliminary safety data for home-based OFC, measured by the proportion of participants experiencing immune-mediated adverse events (AEs), compared with clinic-based OFC. Feasibility metrics (screening to recruitment ratio, protocol completion), non-immune AEs, protocol adherence and quality of life assessed using the Food Allergy Quality of Life Questionnaire-12 at baseline prior to OFC and 6 months post OFC will also be collected. Statistical analysis will include descriptive statistics, with comparisons between arms using risk differences and relative risks with 95% CIs.

The trial has received ethics approval from the Austin Health Human Research Ethics Committee (HREC/111750/Austin-2024). Findings will be disseminated through peer-reviewed publications and scientific meetings. Data will be presented in aggregated, de-identified form.

NCT06916819.

Acute intracerebral haemorrhage (ICH) is devastating with a 1 month mortality rate of ~40%. Cerebral oedema can complicate acute ICH and is associated with poor outcome. In patients with large ICH, the accompanying swelling increases mass effect and causes brain herniation. Mannitol, an osmotic diuretic, is used to treat cerebral oedema after traumatic brain injury, but its safety and efficacy in ICH is unclear. We aim to assess the feasibility of a phase II randomised, controlled trial of mannitol in patients with ICH with, or at risk of, cerebral oedema to inform a definitive trial.

The mannitol for cerebral oedema after acute intracerebral haemorrhage trial (MACE-ICH) aims to include 45 ICH participants from 10 UK sites with estimated largest diameter of haematoma volume >2 cm, presenting within 72 hours of onset with, or at risk of, cerebral oedema (limited Glasgow Coma Scale (GCS)8) with or without mass effect. Participants will be randomised (1:1:1) to 1 g/kg 10% single-dose intravenous mannitol, 1 g/kg 10% mannitol followed by a second dose at 24 hours, or standard care alone. Outcome assessors will be masked to treatment allocation. Feasibility outcomes include proportion of patients approached being randomised, participants receiving allocated treatment, recruitment rate, treatment adherence and follow-up. Secondary outcomes include serum electrolytes and osmolality at days 1–2; change in ICH and oedema volume at day 5; number of participants who developed urinary tract infection, GCS and National Institutes of Health Stroke Scale at day 5±2; length of hospital stay, discharge destination and death up to day 28; death and death or dependency by day 180 and disability (Barthel Index), quality of life (EuroQol, 5-D) and cognition (telephone mini-mental state examination) at day 180.

MACE-ICH received ethics approval from the East Midlands-Leicester Central research ethics committee (22/EM/0242). The trial is funded by a National Institute for Health and Care Research RfPB grant (203080). The results will be published in an academic journal and disseminated through academic conferences and patient support groups. Reporting will be in line with Consolidated Standards of Reporting Trials recommendations.

ISRCTN15383301; EUDRACT 2022-000283-22.