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Biomarkers in Kidney Transplantation (BioKiT)

Supervisors: Dr Stephen Marks, Professor David Long, Professor Lisa Robinson (University of Toronto)

Background:
Renal transplantation can be a lifesaving procedure for children with end stage kidney disease. Unfortunately, kidney rejection remains a major morbidity that limits long-term survival of these patients. Lack of biomarkers with good predictive value for rejection together with the development of novel therapeutic approaches that will transform current care pathways from a reactive approach dependent on symptoms, signs and non-specific tests to a proactive approach may improve renal allograft survival.

Aims/Objectives:
Define a non-invasive molecular biomarker of paediatric renal transplant rejection with diagnostic and prognostic value.

Methods:
RNA sequencing of immune cells isolated from kidney tissue of paediatric renal transplant recipients with rejection and association to clinical characteristics. Cross-sectional, validation study utilising stored biopsy material, blood and urine from patients. Prospective validation of the prognostic value of the novel molecular biomarkers in a cohort of patients undergoing transplantation in two large international centres.

Ethics Approval:
There is some ethical approval for our initial biomarker research but there will be full ethical application for the prospective study.

Collaboration with University of Toronto:
The collaboration with the University of Toronto is crucial for the success of this ambitious project by allowing access to material and patients in one of the busiest centre for renal transplantation worldwide and expertise in the development of biomarkers.

Timeline:
The successful candidate should envisage to complete the first two objectives in the first two years of their training and the third objective in their final PhD year. Vising Toronto for three months in the beginning of the fellowship and then at the end of year two will facilitate the successful completion of this ambitious project.