Researcher seeking answers to kidney quandary

Deciding whether to sacrifice a kidney to improve the health of very sick offspring is seldom a problem for parents of young end-stage kidney disease (ESKD) patients – indeed parents account for up to 65 per cent of paediatric kidney donors for children and adolescents.

The difficulty is in deciding just who should donate – the mother or father.

But a WA Health researcher is hoping to be able to make that decision easier for families.

With the help of a Department of Health-funded Merit Award, Sir Charles Gairdner Hospital consultant nephrologist Wai Lim is investigating some specific factors that are thought to influence compatibility between children and their potential parent donors.

Clinical Professor Lim’s ultimate aim is to develop a method for predicting the parent whose kidney is likely to produce the more successful long-term outcome.

Professor Lim’s research follows recent data that shows children who receive a live kidney from their mother are more likely to experience organ rejection.

The recent findings are contrary to the long-held belief that the choice of parental donor had no bearing on a child’s long-term health after kidney transplantation, making parental donor selection (if both suitable) a largely random exercise.

Professor Lim said differences in immunological compatibility might account for the differences in maternal and paternal kidney transplant outcomes but this remained unknown.

In an effort to find a way of predicting the most suitable parental donor, Professor Lim’s research will focus on a group of genes that determine tissue compatibility in kidney transplantation.

Professor Lim said live kidney transplantation enabled young ESKD patients to avoid harms associated with dialysis and provided them with a substantial survival advantage.

“Giving up a kidney for a sick child is something very special that many parents of young ESKD patients are willing to do,” Professor Lim said.

“We want to make sure that when this happens, transplantation has the best possible chance of long-term success. Knowing which parent will make the most suitable donor will help us do this.”

Professor Lim was one of 30 local researchers who will share in $1.875 million of funding in the latest round of the WA Merit Award program. The program funds Western Australian researchers who narrowly missed out on a National Health and Medical Research Council (NHMRC) grant but whose research was considered meritorious of funding.

The Awards help these researchers to strengthen their grant applications in order to improve their prospects of success in future NHMRC funding rounds.

A full list of FutureHealth WA Merit Award recipients can be found here.

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