New research conducted by the Paris Translational Research Center for Organ Transplantation team could help clinicians determine which patients will have a disease that usually occurs after a kidney transplant and which are at high risk of transplant failure. The results are published in the prestigious Journal of the American Society of Nephrology (JASN).
Transplant glomerulopathy is a disease associated with the loss of a kidney transplant. There is currently no treatment for this heterogeneous disease.
This research was able to identify and characterize five distinct patient groups, each with different graft survival outcomes.
This research approach has been translated into a tool accessible to clinicians to assess the risk of graft loss in their patients. This will allow the individualization of patients' treatments according to their group.
World Kidney Day, promoted in France by the Kidney Foundation, will take place on March 14. This year, the theme chosen was inequalities in the prevention, early detection and treatment of kidney disease worldwide, under the slogan "Healthy kidneys for everyone, everywhere".
According to the WHO, chronic kidney disease has become a public health issue affecting 10% of the world's population. In France, 3 million people suffer from it and 87,000 of them are treated by dialysis or receive a kidney transplant. For Health Insurance, the cost of this care represents 2% of its total expenses, or €4 billion per year.
This is why the Future Investments programme is providing €9 million to support the KTD-innov research project.
Research responds to a real need of patients
For people with severe chronic kidney disease, a transplant is often the ideal choice because it is less restrictive and less expensive than dialysis. Unfortunately, in France, less than 4,000 people a year are lucky enough to receive a new kidney, and 1,500 people are still on waiting lists.
The law of 26 January 2016 on organ donation has made it possible to generalise it but is not enough to sufficiently reduce the list of patients waiting for a kidney transplant. And it happens regularly that patients who have already had a transplant need a new organ a few years after their transplant. That is why the KTD-innov project is looking for a solution to make the graft viable for longer. This solution will allow a personalized medical follow-up of transplanted patients.
Innovation in research
The KTD-innov project offers a unique approach that combines clinical, biological, immunological and molecular data from the patient. It allows a global vision of the patient and a unique analysis in the world.
Thanks to funding from the French government, KTD-innov will improve knowledge and predict the success of transplants. It is thanks to this innovation that patients can already expect an individualization of their treatment and an increase in the life of their graft by 2022.
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The 2019 Cutting Edge of Transplantation (CEoT) took place between the 21st and the 23rd of February 2019 in Phoenix, USA. This year’s theme was “No size fits all: uncovering the potential of personalized transplantation”.
Their goal for their meeting each year is to see the advancement of individualized care for transplant patients through new algorithms or practices, for the duration of their transplant journey.
That is why, Dr. Alexandre Loupy presented the work of the KTD-innov team with two oral presentations, presenting the advancement of the research and how it could help transplant patients in the future by minimizing rejection risks.
The CEoT is a meeting organized each year since 2013 by the American Society of Transplantation (AST). The organization was founded in 1982 and now counts 3 800 health professionals. Their goal is to promote both the field of transplantation and patient care through research, education, advocacy, and organ donations.
Interview with Sophie Brouard, research director at the University Hospital of Nantes and co-coordinator of KTD-innov
The Société Francophone de Transplantation (SFT) will host solid organ transplant specialists in Toulouse from December 4 to 7, 2018. Partners of the KTD-innov project are present at the event.
Agnès BUZYN, Minister of Solidarity and Health, Frédérique VIDAL, Minister of Higher Education, Research and Innovation, and Louis SCHWEITZER, Commissioner General for Investment, announced at the end of 2017 the allocation of €74.5 million to the 10 winners of this third call for projects "Hospital-University Health Research" (RHU).
The call for projects "University Hospital Research in Health" (RHU) of the future investment programme, operated by the National Research Agency, aims to support innovative and large-scale research projects in the health sector. Focused on translational research, HRU projects combine the academic, hospital and business sectors.
For this third wave, the international jury examined 52 proposals on the basis of scientific quality and innovation criteria, but also on their potential for medical and socio-economic benefits. It proposed 10 projects for funding covering various therapeutic areas and needs. These projects demonstrate that French excellence in certain future technological fields is becoming a central element for biomedical research. Many projects rely on genomic analysis and big data for the development of diagnostics or treatments. Digital technologies are also present in the selected folders (imaging, connected implants etc.).
The collaborative requirement has helped to strengthen links within the university hospital ecosystem (health institutions, research organizations and universities) not only on one site, but also throughout the country, with many projects bringing together expertise from different regions.
LIST OF FUNDED PROJECTS
The KTD-innov project, (€8,794,510) aims to prevent the loss of kidney transplants by improving the diagnosis of rejection, predicting the risk of long-term graft loss and response to anti-rejection treatment. KTD-innov has set itself the goal of being the first integrated solution in kidney transplantation that combines molecular medicine and health information technology to provide a precision immune monitoring and diagnostic system for kidney transplantation. The project is led by Prof. Alexandre Loupy (Paris).
The CiL'LICO project, (€5,976,352) proposes a new approach for the management of a group of rare and serious genetic diseases, ciliopathies that cause deterioration of renal function and lead to end-stage renal failure. The project is led by Professor Stanislas Lyonnet, Director of the Institut Hospitalo-Universitaire Imagine (Paris).
The cirB-RNA project, (€5,910,166) aims to develop a diagnostic test to support the development of curative treatments for hepatitis B, which currently does not exist despite a disease that affects more than 240 million people worldwide. The project is led by Prof. Fabien Zoulim (Lyon).
The EPINOV project, (€5,800,000) aims to improve neurosurgical strategies by introducing an innovative approach to brain modeling. Using epilepsy as a model, the patient's "virtual brain" will allow the epilogenetic zone to be more precisely located, thus guiding an optimal surgical strategy and consequently improving surgical outcomes. The project is led by Prof. Fabrice Bartolomei (Marseille).
The FollowKnee project (€7,900,000) proposes to improve the design, placement and monitoring of implanted prostheses, the number of which has exploded over the past 20 years (+600%), particularly because of their implantation in a younger population often affected by obesity. FollowKnee is led by Prof. Eric Stindel (Brest).
The MyProbe project, (€9,294,317) aims to develop effective tools to identify the high risk of breast cancer relapse and reduce the use of costly and cumbersome additional treatments for patients. MyProbe is led by Professor Fabrice André of the Gustave Roussy Institute (Villejuif).
The PERFUSE project, (€8,000,000) proposes to improve the management of prostate cancer by using high-intensity focused ultrasound (HIFU) ablation to target only the area where the tumour is present. The project is led by Professor Sébastien Crouzier (Lyon).
The PIONeeR project, (€8,502,312) aims to overcome resistance to immunotherapy treatment against the PD-1 checkpoint inhibitor in the treatment of lung carcinoma. The introduction of these new therapies has led to considerable progress, but only 20 to 25% of patients are fully responsive and to date, no predictive factors of efficacy or resistance have been validated. The project is led by Prof. Fabrice Barlesi (Marseille).
The QUID-NASH project, (€8,745,683) aims to revolutionize the management of non-alcoholic hepatic steatosis (NASH) associated with type 2 diabetes by developing a virtual biopsy that will allow patients to be better diagnosed and stratified, but also to facilitate the development of specific NASH treatments. The project is led by Prof. Dominique-Charles Valla (Paris)
The WillAssistHeart project, (€5,600,000) aims to propose new strategies for the diagnosis and treatment of bleeding in patients under mechanical circulatory assistance. The consortium will focus its work on the best-known bleeding risk factor: von Willebrand factor. This factor is sheared when exposed to blood flow disturbances created by the mechanical circulatory support device. The project is led by Professor Sophie Susen (Lille).
To elucidate the mechanisms of success or failure of a kidney transplant, KTD-innov collects, centralizes and analyses clinical, biological and immunological data from thousands of kidney transplant patients in France.