Transplantation is the treatment of choice for patients whose kidneys have failed, providing superior survival, better quality of life and lower health-care system costs (<$20,000/year vs. > $90,000) compared with dialysis. However, a severe form of rejection (known as antibody-mediated rejection, or AMR) causes premature loss of the transplant kidney in as many as 30 per cent of transplant recipients, or 500 Canadians every year, prompting a return to dialysis and often early death.
The team led by Drs. Paul Keown and Stirling Bryan of the University of British Columbia, Ruth Sapir-Pichhadze of McGill University and Timothy Caulfield of the University of Alberta, which includes over 70 scientists and clinicians from 22 universities in Canada, the US, the UK and the EU, will use genomic technologies to reduce the risk of AMR. These will enable better matching of patients and donors, precise monitoring of the immune response after transplantation to better predict AMR, and the use of personalized drug treatments to prevent rejection while avoiding infection or cancer. The team will also engage patients, providers and health care payers to study the legal, ethical, societal and economic considerations of introducing these strategies into clinical practice.
The goals of the research program are to reduce the frequency of AMR by at least 50 per cent and in so doing to benefit first the patient and his or her family through improved survival and quality of life, reduced caregiver burden and personal health costs; second to minimize demand on the health-care system by reduced costs through decreasing dialysis and re-transplantation, and third to improve societal care of a major chronic disease by increasing productivity and streamlining the management of chronic kidney failure.