CANPREVENT

Chronic kidney disease affects 1 in 10 Canadians with estimated costs of over $2 billion/year. 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 ($15,000 vs $55,000/yr) 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 program builds on our highly successful national transplant program coordinated through the Canadian Blood Services (CBS) and links 16 major transplant programs, 9 leading universities, and 14 provincial transplant organizations and laboratories in Canada, the US, the UK and the EU, which will use genomic technologies to reduce the risk of AMR. It is led by an experienced Canadian and international team of genome experts, transplant immunologists, clinical scientists, legal scholars, ethicists, and health economists, working collaboratively with patients, members of the public, health providers, provincial health organizations, national coordinating bodies and commercial partners. 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.

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Our lab is currently working on identifying efficient means of sequencing transplant donor and recipient samples towards transplant rejection prevention. We are employing Illumina and Oxford Nanopore technologies towards finding the fastest means of completing human leukocyte antigen (HLA) immunotyping. This work will inform transplant physicians of the available tools for ensuring fast and safe matching of donors and recipients using state-of-the-art genetics technologies.

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Read more at: Genome Quebec