Past Grants
2023/2024
Utility of esophageal function assessment in predicting risk of lung allograft dysfunction in lung transplant recipients – A single- center, prospective study
Lung allograft dysfunction is a major complication after lung transplantation, which can occur at various times following surgery, either as chronic or acute rejection. Chronic lung allograft dysfunction is a leading cause of morality beyond the first-year post-transplant. Gastroesophageal reflux and aspiration- induced lung injury have been recognized as a potential trigger for both acute and chronic lung allograft dysfunction and poor outcome.
Dr. Moosavi’s research team will look at the role of esophageal function assessment before and after lung transplantation to create a predictive model of lung dysfunction.
The finding of this study will help guide patient-specific treatment plans to reduce lung injury, including pharmacologic options as well as surgical anti-reflux intervention, which can be performed simultaneously during the lung transplant surgery.
Principal investigator Dr. Sarvee Moosavi
Co-investigators: Dr. John Yee, Dr. James Choi, Dr. Ronald Nador, and Dr. Anna McGuire
For an up-to-date list of publications by Dr. Sarvee Moosavi, please see ResearchGate
2022/2023
A Novel CMV-Specific Cell-Mediated Immunity Assay to Predict CMV Infection in Renal Transplant Recipients – A Pilot Prospective Study
Dr. Sara Belga’s project seeks to design a blood test to assess immunity to Cytomegalovirus (CMV) to personalize care in kidney transplant patients.
CMV is a common virus that typically does not cause serious problems in people with normal immune systems. Following transplantation, anti-rejection medications can dampen the immune system, allowing the virus to resurface and cause problems. Currently, transplant patients who are at risk of developing CMV infection are given antiviral medications; however, these medications can have serious side effects.
The goal of this study is to trial one immune monitoring test in kidney transplant patients to assess those at risk for CMV infection. Blood tests will track patients’ immune system during the first-year post-transplant to identify warning signs before patients develop CMV disease. This test will be a personalized approach to CMV monitoring that may improve patient outcomes by allowing for early identification of those at high risk of CMV infection.
Principal investigator Dr. Sara Belga
Co-investigators: Dr. Allison Mah, Dr. Alissa Wright, Dr James Lan, Cindy Luo, Dr. Inna Sekirov, Dr. Ted Steiner, and Dr. Laura Cook
Patient Partner: Paul Albrighton and Shelby Gielen
For an up-to-date list of publications by Dr. Sara Belga, please see ResearchGate
2020/2021
Genotype-guided voriconazole prescribing in lung transplant recipients
Pharmacogenomics is the study of how the variation in a person’s DNA can affect drug response, helping predict how well a drug will work and the potential for drug side effects. The intent of this project is to learn about whether pharmacogenomic testing can help tailor medications for transplant recipients.
Lung transplant recipients require potent life-long immunosuppressive medications to prevent organ rejection; however, chronic suppression of the immune suppression increases the risk of life-threatening fungal infections such as Aspergillosis. The medication of choice for treatment and prophylaxis of Aspergillus infection is voriconazole (VRC). VRC requires routine therapeutic drug monitoring (TDM) as low drug concentrations are predictive of treatment failure and high concentrations are associated with significant toxicity. It is anticipated that genetic variation in some lung transplant recipients will result in customized medication plans that will reduce side effects or improve medication efficiency.
Patient partners play an integral role throughout this project, from the development of patient-specific education materials on pharmacogenomics to creating patient surveys that will describe the patient perspectives on using pharmacogenomics in transplant care. This project will improve the care of transplant recipients through customization of medications.
Principal investigator Dr. Cindy Luo
Co-investigators: Dr. Robert Levy, Dr. Roland Nador, Dr. John Swiston, and Dr. Celine Bergeron
Patient Partner: Larry Worfolk and Christine Kapeluck
For an up-to-date list of publications by Dr. Cindy Luo, please see ResearchGate
2019/2020
Pre-transplant multidisciplinary assessment of medication adherence and transplant outcomes
For patients who undergo a kidney transplant, one of the major factors that contribute to premature transplant failure is the lack of adherence to immunosuppressant drugs. Risk factors for non-adherence include a lack of health literacy and self-efficacy, and cognitive deficits.
To help improve adherence rates, this study will examine use of a personalized patient-adherence plan. Kidney transplant patients will be recruited during routine pre-transplant evaluations to participate in a one-month adherence assessment using mock immunosuppressant medication, as well as assessment of their health literacy, self-efficacy and cognition. During this period, patients will be required to make dose adjustments to mimic the medications changes that are typically required after transplantation. Based on the results, a personalized patient adherence plan will be developed and shared with the patient to assist them with their medication adherence following their transplant surgery.
“This study has the potential to transform the current standard of care for all organ transplant recipients at St. Paul’s Hospital and Vancouver Coastal Health,” says Leung. “Because the plan will be approved by patients themselves, they will be more engaged in their own care and establish a more positive relationship with their care teams.”
For an up-to-date list of publications by Marianna Leung, please see ResearchGate