The next phase of the CNTRP is about building on our successes. Our expanded vision—the major leap forward—is that Canada fulfills every donation opportunity and realizes the vast potential of transplantation as a true, cost-effective cure for many chronic diseases and refractory blood cancers. We call this the One-Transplant-For-Life challenge. It stems from the CNTRP’s success, plays to Canada’s strengths, and is the direction Canada needs to take to improve health outcomes.
We have redesigned our platforms to enhance collaboration, leverage resources for investigators and target areas of research identified as priorities. Further, we have refocused the research themes that are at the heart of our collaborative efforts to support innovative science.
OUR FIVE INTER-RELATED THEMES
Theme 1: Create a culture of donation
The gap between the need for donated organs, tissues and cells and actual donations is the fundamental bottleneck to increasing life-saving transplants for Canadians. Evidence and experience suggest that creating a culture of donation in our hospitals, governments and society is an essential component of improving the performance of the donation system. This theme will study methods to measure, create and implement a culture where the benefits of organ, tissue and cell donation are valued by stakeholders across the donation process using. Theme 1 will aim at 1) increase understanding of the stakeholder experience during the donation process, 2) Develop and implement knowledge transfer tools and 3) explore the ethical, legal and economic impact of emerging donation practices.
Theme 2: Inform universal practices for donation
With our partners and stakeholders, we have made great strides to improve the donation process and develop the field of donation sciences in Canada. The mandate of this new theme is to build on this success and seek to improve transplant yield from willing individuals, living or deceased, who are in a position to donate imminently. This theme will explore opportunities for expanding and optimizing the donor pool in the following 3 streams: 1) Expand the criteria for eligible donors. 2) Improve care for deceased donors. 3) Identify predictors of organ non-function.
Theme 3: Engineer and allocate better grafts
Events occurring during the immediate pre- and post-transplant periods dictate long-term transplant outcomes. Opportunities are becoming available to enhance the organ allocation process to obtain a better match with the recipient. With recent technological advances, and building on discoveries from the CNTRP, investigators can begin to explore modifying and manipulating the graft as well as the recipient before transplant to improve short- and long-term outcomes. Theme 3 will develop novel strategies for 1) the Assessment of tissue damage and impact on transplant outcomes 2) Ex vivo organ perfusion treatments, 3) HCT grafts engineering and 4) Optimization of Graft allocation.
Theme 4: Tailor an optimal immune system for each patient
Patients with organ or islet transplants live with the life-long possibility of rejection, whereas recipients of HCT face the reverse problem: GVHD (where the newly-transplanted immune system attacks the body). The immunosuppressive medications that keep rejection and chronic GVHD at bay do so by suppressing all immune responses, leaving patients with multiple side effects and at high risk of infections and cancer. Theme 4 will develop Immunomodulation strategies to control immune responses to foreign antigens—but not at the expense of normal immune function. This will allow the creation of personalized immune strategies, reduce the need for life-long immunosuppressive medication and increase the likelihood that a transplant will be a true cure. As infectious complications are important contributors to post-transplant morbidity, mortality and graft loss, Theme 4 will also study immunity to infections to develop risk prediction tools and therapies to prevent or treat infectious complications.
Theme 5: Restore long-term health
While quality of life generally improves after transplantation, in the long term, many patients do not return to their expected level of function and fulfillment. Adverse side-effects and other complications from immunosuppressive medications, complex factors leading to graft failure and sometimes recurrence of the original disease all hinder a return to expected levels of function and fulfillment. Theme 5 builds on momentum created in the CNTRP to unite investigators across Canada with expertise in SOT, HCT, physical rehabilitation, psychology, qualitative research and health economics to integrate and develop projects focused on developing patient based Long-term data and metrics and returning recipients to a full quality of life.
Our cross-cutting research priorities inform all themes
Everything we do, every study we develop, co-fund or manage with our partners must address our cross-cutting research priorities:
Sex and gender
Pediatric, adolescent and elderly
Indigenous, rural and remote populations
Patient and family researcher partnership
Policy, commercialization and knowledge transfer
Associate Scientific Director
THEME 1 TEAM
THEME 2 TEAM
THEME 3 TEAM
THEME 4 TEAM
THEME 5 TEAM