Personalized immunomodulation after kidney transplant using donor-derived thymic epithelial cells
Institution: University of British Columbia
Years: 2026-2027
Topic(s): Transplantation
Lay Abstract
Kidney transplantation gives children with kidney failure the opportunity for a longer, healthier life, but every child's immune system is different. Some children develop early rejection or persistent inflammation that damages their transplanted kidney, while others thrive on standard treatment. Today, we lack the tools to predict before transplant which children carry an inherently higher immune risk, leaving clinicians unable to tailor immunosuppression to the individual child.
Answering this challenge sits at the heart of CDTRP's vision: to tailor an optimal immune system for each patient. This study will examine 42 variations across 28 immune-related genes in DNA samples from 200 pediatric kidney transplant recipients in British Columbia. Each gene variant has been individually linked to rejection or graft failure in other studies; however, we propose to understand how they interact in aggregate to shape each child's net immune response after transplantation.
Using Oxford Nanopore adaptive sampling, a novel sequencing strategy, we will build individual genetic risk profiles and connect them to real clinical outcomes: kidney biopsies, urine inflammatory markers, and long-term graft survival. Machine learning will identify which combinations of variants best predict early rejection, allograft inflammation, and graft failure.
The result will be a personalized pre-transplant immune risk score to guide donor selection, monitoring intensity, and immunosuppression dosing for each child. Patient, family, and donor partners are embedded throughout this work, co-developing how findings are interpreted and communicated, and ensuring that this genetic risk tool is meaningful, trustworthy, and ready for real-world clinical implementation. This precision approach directly supports the CDTRP mission of moving transplant medicine from reactive to proactive, individualized care.
