Local Research Team Hopes to Discover New Test to Help Pediatric Transplant Patients

Keith Morris and his wife, Karen remember the moment they welcomed their son, Kaden into the world. They were both overcome with emotion at the birth of their third child however, within hours their joy would turn to concern. Just 24 hours after birth, Kaden was diagnosed with renal failure. Two days later, he was put on dialysis and remained in the hospital for three months.

Then in March of 2008, Kaden received a life-saving kidney transplant at the Children’s Hospital in Winnipeg. But his path to a healthy life was far from certain. Approximately 10-20% of children who receive a kidney transplant will experience at least one rejection episode in the first year after transplant. Over time, up to 40% will have at least one rejection episode. Kaden, now 3-years-old, was extremely fortunate. He thrived after surgery and while his parents watched for common signs of a rejection, Kaden’s transplant proved to be quite a success.

However, many children aren’t so fortunate, and that is why Dr. Blydt-Hansen, a scientist at the Manitoba Institute of Child Health, the research division of The Children’s Hospital Foundation, and Head of Pediatric Nephrology and Assistant Professor of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, is working with his colleagues on a new test to help kidney transplant patients. Currently, a kidney biopsy is needed to detect rejection; however, Dr. Blydt-Hansen is studying ways to perform a simpler and less invasive test on urine that could be done regularly to detect early signs of rejection.

Dr. Blydt-Hansen is using a technique called Nuclear Magnetic Resonance (NMR) spectroscopy. The NMR uses a magnetic field to measure the amounts of different metabolites that everyone has in their urine. Metabolites are small molecules produced and used by our cells and include simple sugars, amino acids and waste products. Dr. Blydt-Hansen says, “The premise for our study is that amounts of these metabolites will change as a result of the rejection process.” Blydt-Hansen adds, “If we can distinguish these patterns, that will allow us to detect rejection early and then begin treatment to protect the kidney transplant and improve the long-term kidney function.”

Preliminary results have shown more than 90% accuracy in being able to differentiate between the samples with and without rejection. Dr. Blydt-Hansen and his research team hope to be able to design a test that can be used in the clinic. This should help reduce the number of biopsies that children with transplants will need and help identify children with possible early rejection.

The Manitoba Institute of Child Health is the research division of The Children’s Hospital Foundation. The Institute is dedicated to excellence in pediatric research. At the Institute, more than 220 world-class pediatric medical researchers, technical staff, students and support staff are involved in over $8 million of research and clinical trial activities each year.
 
Fast Facts about Pediatric Kidney Disease

• In Manitoba, approximately 700 children per year are admitted to hospital with various forms of kidney disease.
• A small number of them will experience progressive kidney failure and will require dialysis or a kidney transplant to survive.
• Children with end-stage kidney failure struggle with complications from kidney failure such as anaemia, bone problems, high blood pressure and heart disease, nausea with poor appetite and growth problems.
• Most children are eligible to receive a kidney transplant, and in those cases it can dramatically improve their health and long-term survival.
• Living with a kidney transplant requires life-long treatment with medications to prevent kidney transplant rejection.
• 10-20% of children with kidney transplants will experience at least one rejection episode in the first year after transplant. Over time, up to 40% will have at least one rejection episode.

 
Kidney Disease by the Numbers

• Number of children being followed with chronic kidney failure who may need a transplant in the future: 48
• Number of children being followed after transplant in the Pediatric Kidney program: 40
• Number of pediatric kidney transplants per year in Manitoba: 5-8
• Total number of transplants per year in Manitoba: 40-50
• Number of kidney transplants per year in Canada: >600.
• 1 in 10 kidney transplants is for a child

(Winnipeg, Manitoba – September 9, 2009)