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Investigating the role of metabolism in predicting outcomes in Pediatric transplant patients

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Dr. Tom Blydt-Hansen, Dr. Simon Urschel, Dr. David Wishart, Dr. Kathryn Armstrong

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For children with kidney or heart failure, a transplant is life-saving. But living with a transplant means depending on medication that block the immune system from damaging the organ – a process referred to as rejection. But everyone is different, and the medications that prevent rejection also have side effects. Some kids seem to have much more risk from rejection than others, and others would benefit from less medication – but right now we can predict who needs more and who needs less.

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We think these differences may have to do with how sick they are at the time of the transplant. So a test before transplant that can tell us would allow us to improve how we prevent rejection, and avoid unwanted side effects from treatment. One way to tell how someone is doing is to look at their metabolism – which we can see in a blood test. We can look at hundreds of small substances that are part of normal metabolism, and use detailed math to discover patterns that are related to a high risk or a low risk for rejection. This is the testing we are doing for the study.

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At present, we have assembled samples from children who have had heart and kidney transplants. We have collected detailed information on how they are doing after transplant, and we are sending samples now to be tested at “the Metabolomics Innovation Center”, which is a leading laboratory in Edmonton – a collaborator on the study. We expect to get early results back in the next 3 months, and from there we will be able to further refine what we are doing. Ultimately, we hope to test this out in a national study that helps us to get the best results for kids in Canada!

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