Current Venture Grants

2023-2024

Dr. Jagbir Gill – A unique reciprocity-based strategy to improve living kidney donations in British Columbia: Focus Group Consultations

Despite the tremendous benefits of kidney transplantation, the demand for transplantation far exceeds the availability of organ donors in Canada, meaning patients have to wait years on dialysis before receiving a deceased donor kidney transplant (DDKT). Deceased donor rates have not changed since 2020. Further, there are limited living kidney donors in Canada and the numbers continue to stagnate. One of the things that limits potential living donors is the concern that someone they know, or love may need a kidney in the future and if they donate now they won’t be able to help other family members.

This project will explore the acceptability of policy in which living kidney donors would be able to identify someone who could receive a priority for a DDKT if they need it. As this would have important implications it is important to understand whether such a policy is acceptable to key stakeholders.

The research team will conduct focus group consultations with patients that are on the waitlist and those that have already been transplanted, living kidney donors, and general community members to explore the acceptability of reciprocity-based strategy. The results will be analyzed and reviewed with the key knowledge users and stakeholders, and policy briefs and reports will be developed to directly inform the development and implementation of reciprocity-based strategy in British Columbia.

Dr. James Lan – Accelerating the Translation of a Novel Luminex Anti-ABO Antibody Detection Technology to Expand the Use of ABO-Incompatible Transplantation in Canada

“We are very excited and thankful for this TRF/CDTRP funding and support which will help us accelerate the translation of a new technology that can increase the safe use of ABO-incompatible transplantation to provide life-saving transplants for patients currently excluded from transplantation.” – Dr. James Lan

Although kidney transplantation offers better patient survival and quality of life over dialysis treatment, many patients on the transplant wait-list have a hard time finding a match due to their blood type. The ABO blood group of a patient is one of the most important factors that determines their ability to find a match. In Canada, patients that are blood group B and O experience much longer transplant wait-times compared to patients with other blood groups (A and AB).

To overcome this problem, doctors can perform transplantation across blood groups (ABO incompatible transplantation) to help difficult to match patients. However, this approach is not used widely as it can increase the risk of rejection. This is because doctors cannot reliably tell based on the current lab test which patients are safe to transplant across the ABO blood group. In a breakthrough development, Lan’s research group developed a new lab test (Luminex method) which can better assess the risk of rejection in patients that choose to receive an ABO-incompatible transplant.

The research team will apply the Luminex test to understand why some patients develop rejection when they receive an ABO-incompatible transplant while others don’t. In addition, they will test blood samples from patients on the current transplant wait-list to advise clinicians whether ABO-incompatible transplantation is a good treatment option. This research is innovative as it has the potential to safely allow for transplants that would previously not occur and greatly expand the transplant opportunities for patients awaiting a kidney transplant.

Dr. Mypinder Sekhon – Characterizing the cerebrovascular physiology of circulatory death during withdrawal of life sustaining therapies in humans

“This funding opportunity provides our research group with the requisite infrastructure and support to undertake a study which could be provide invaluable insights into donation process and help guide donation practices. We are truly so grateful.” – Dr. Mypinder Sekhon

Organ donation may proceed only after the brain’s function / blood flow are lost and death is declared. It can occur after withdrawal of life support machines while waiting for the heart to stop delivering blood flow and oxygen to the brain. This process is called donation after circulatory death (DCD). In DCD, death is determined when the pulse pressure (generated by the heart beat) is less than 5mmHg for a period of 5 minutes. However, owing to the disease characteristics of eligible organ donation patients (i.e. increased pressure inside the skull from a swollen brain), the brain is likely to lose its function and blood flow before the loss of heart function results in this very low blood pressure in the body. This delay in declaring death leads to a prolonged period of waiting during which the eligible organs become increasingly dysfunctional. This may lead to missed opportunities to donate organs or to worse outcomes when the organs are transplanted into patients who need them.

The research team will conduct a prospective feasibility study to characterize the moment of loss of brain blood flow with microcatheters that have been inserted into the brain during the management of the patient. By doing so, the team will identify the moment and pulse pressure at which the brain’s blood flow has ceased. They will also use a brain ultrasound to compare its accuracy in non-invasively determining the moment and pulse pressure at which the brain loses blood flow. By doing so, this study will provide the foundation to conduct a larger multisite study to definitively determine the moment that brain blood flow stops using brain monitoring devices and expedite the process of DCD.

Dr. Christopher Nguan – Machine Learning Enabled Optimization of Perioperative Hemodynamics in Renal Transplantation

Kidney transplant is the best treatment for people with kidney failure, but there are never enough organs for transplant for everyone who needs them.

Making kidney transplants last as long as possible is a goal shared by everyone. In order to get a kidney transplant the patient needs to have major surgery. This research project is geared towards making an artificial intelligence model for the operating room that can take all the data from the kidney donor, the kidney itself and the kidney recipient and make the best plan for how to optimize the many drugs and IV fluids used in the OR and afterwards to make the kidney work right away. This artificial intelligence will be able to make personalized plans for each patient having an operation, no matter how sick they are, or what quality of donor kidney they receive. Before this research, these types of calculations could not be done because there are too many factors to keep track of, but with artificial intelligence, the computer can be trained to help doctors improve kidney transplant survival for the long term.