Maureen Phillips puts a positive spin on the multitude of tissue biopsies she’s endured since receiving her heart transplant in February 2007. “It’s not pleasant, but at least I get to see the friendly staff at the transplant clinic,” she says.
Tissue biopsies are currently the only way to monitor transplant patients for organ rejection. They’re also an invasive but necessary tool for individually fine-tuning the dosage of immunosuppressive drugs required by every transplant patient. Too small a dosage can result in organ rejection and potential organ failure; too much leaves patients susceptible to dangerous infections and cancer.
Biopsies are costly
In addition to being uncomfortable and stressful for patients, biopsies are costly: heart transplant patients undergo at least a dozen biopsies in the first year after transplant, at a cost of $5,000-$10,000 for each.
However, there is now hope that made-in-BC research may soon make post-transplant biopsies unnecessary. A team at the Centre of Excellence for the Prevention of Organ Failure (PROOF Centre) in Vancouver has discovered a promising and cost-effective new way to predict and diagnose rejection in heart and kidney transplants. The new testing method involves screening for specific combinations of proteins or genes, called “biomarkers,” that can be detected in blood or urine samples.
“The ability to predict and diagnose rejection of transplanted organs with a simple, inexpensive blood test would significantly reduce the need for biopsies,” says Dr. Bruce McManus, PROOF Centre Director. “It would also allow physicians to respond very quickly to the earliest signs of organ rejection.”
As part of its contribution to this study BC Transplant recruited 760 patients – including Maureen Phillips – for the first phase of research, which was to identify the most effective biomarkers for detecting organ rejection. Currently in its second phase, the study is now confirming the reliability of its selected biomarkers in a trial with patients across Canada.
Failure costs account for 30% of system resources
Treatment related to organ failure, including everything from open heart surgery and kidney dialysis to organ transplants, is a significant area of cost to the Canadian healthcare system, accounting for more than 30 percent of system resources.
If successful, the PROOF Centre’s new organ rejection test promises some welcome savings within this expensive area of care. By reducing or eliminating the need for tissue biopsies, estimated cost savings for heart transplant patients alone are expected in the tens of millions of dollars every year.
And then there is the benefit for patients like Phillips, who will no longer need to endure unpleasant biopsy procedures. “It will be a wonderful day when transplant patients like me can simply provide a blood or urine sample to see how their transplant is doing,” says Phillips.
Research Funders
- PROOF Centre of Excellence
- Genome BC
- Astellas Pharma
- University of British Columbia - Vice President Research
- St. Paul's Hospital
- BC Transplant
Dr. Bruce McManus is director of the PROOF Centre of Excellence for Commercialization and Research and a professor in UBC’s department of pathology and laboratory medicine. He also provides biopsy support for BC’s heart transplant program through Cardiac Services BC.