Could personalised care for kidney transplant patients improve their outcomes?
Dr Rhys Evans, from University College London has received a Professor Michael Nicholson Award start-up grant of £39,000 to investigate systems and tests that tell us about the health of a kidney transplant, to see how they could lead to personalised care for kidney transplant patients in the UK.
Improvement is needed to make kidney transplants last longer
Transplant patients must take drugs, immunosuppressants, that reduce how well their immune system works to protect their new kidney and prevent their immune system from rejecting it. However, these drugs make it harder for the immune system to fight off infections and they can also come with unwanted side effects.
Some patients may require more of these drugs than others, and how much an individual patient needs can change over time. Knowing how what type of treatment, and how much of it, to give to each patient can be challenging. This is partly because we do not have accurate tests in routine clinical use in the UK that tell us about the health of the kidney transplant or to what extent the immune system has been impacted by the immunosuppressant medications.
Recently, several different tests have been developed to more accurately monitor how the kidney is functioning. These are called precision medicine techniques and have shown promise in Europe. We now need data to test their feasibility and effectiveness in the UK.
What is personalised care?
Offering individuals their own treatment plan based on their health conditions and needs is called personalised care. It represents a new relationship between people, professionals and their healthcare system.
Testing current systems for personalised care
During this project, Rhys and the team will look at the several systems and tests including:
- A transplant outcome prediction system that uses a computer to calculate what the likely outcome for the kidney transplant will be
- Blood and urine tests that detect damage within the kidney
- Genetic signals in kidney biopsies that might be able to give a better guide to what treatments to use.
They will investigate systems and tests by applying them to results from previously transplanted patients in the UK to see if having such strategies would have changed the decisions made by both patients and doctors. They will then test the feasibility of the new tests going forward.
What does this mean for kidney patients?
This project will provide us with more evidence on the impact that precision medicine may have on patient care in the UK. This will help to pave the way for future studies to look at how these systems and tests could allow personalised transplant care.
“We need better ways of individualising immunosuppression in kidney transplant recipients. To do so, we need to firstly understand how feasible and reliable current precision medicine techniques are, that might help us to do this - and we thank Kidney Research UK for their funding which will allow us to investigate this.” Rhys Evans.
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