Assessing Donor kidneys and MonitorIng transplant REcipients (ADMIRE)

Research summary

Kidney transplantation is the optimal treatment for chronic kidney failure, offering extended life and freedom from dialysis. However, in 2019/20, of the 8,300 UK patients on the transplant list, only 3,400 received a kidney, while 3,300 were suspended, and 400 died waiting. To address the organ shortage, more kidneys from higher-risk donors, such as those donated after circulatory death (DCD) or from older/sicker individuals, are being used. These kidneys are at greater risk of poor long-term function, often requiring recipients to return to dialysis. Since 2010, the use of DCD kidneys, which are prone to oxygen deprivation injury, has nearly doubled, now comprising 40% of UK transplants. Similarly, over half of donor kidneys now come from individuals over 59 years old. Despite increasing availability, these higher-risk kidneys contribute to poorer outcomes, with 13% of recipients in 2017 and 16% in 2019 experiencing low kidney function within the first-year post-transplant, increasing the likelihood of returning to dialysis. Annually, about 850 transplant recipients return to dialysis, reducing future transplant options and impacting patient outcomes. Current methods cannot reliably predict how well donor kidneys will perform post-transplant or monitor their long-term health. To improve this, we aim to develop non-invasive techniques to assess kidney viability and monitor its function. This includes refining scanning methods. We will use a technique called Magnetic Resonance Imaging (MRI) to generate internal pictures of whole kidneys. This initial study will evaluate 15 donor kidneys before transplant and monitor their recipients three months post-transplant. Successful completion of this study will lead to a clinical trial that will study both the benefit of the model used to better assess donor kidneys as well as the role of scanning to improve monitoring after transplantation.

Principal Investigator

Dr Edward John Sharples

Contact us

Email: renalandtransplanttrials@ouh.nhs.uk

IRAS number

344942