Novel tools to improve kidney allograft selection

Renal transplantation has been established as the preferred treatment for patients with end-stage kidney disease. It provides better quality of life by sparing patients from lifelong dialysis and reduces morbidity and mortality. For most patients with end stage kidney disease without a living donor, deceased donor kidney transplantation remains the best option for extended survival compared to dialysis. In Switzerland, 1450 patients are currently on the waiting list for an organ transplant.

News tools to identify kidney at risk of primary nonfunction or early graft failure are needed to guide acceptance decisions. Indeed, pursuit of development of strategies to improve kidney allograft selection are priorities to reduce unnecessary discard and increase access to transplant for patients in need.

With this Ambizione grant I plan to developp new tools to improve kidney allograft selection. In particular, I plan to developp mulimodal Magnetic Resonance Imaging (MRI) to assess quality of the kidney before the transplantation. It will establish if multimodal MRI can assess quality of the kidney and predict evolution of kidney renal function at 2 years. Moreover, I plan to identify biomarkers from transcriptomic signature in pretransplantory renal allograft biopsies and urine. It will establish if pre-transplantation biospy and/or urine sample can predict evolution of kidney renal transplant at 2 years.

Altogether, I will use different approaches to determine whether multimodal MRI and biomarkers could become novels tools to assess the quality of a donor organ prior to transplantation. This will help to evaluate the risk of early graft dysfunction and rapid graft loss risk and therefore minimize the discard rate.