Grant: Collaborative Health Research Projects (NSERC partnered)

Over 5400 Canadians were diagnosed with kidney failure in 2011, and numbers of patients requiring treatment for this condition have more than tripled in the last 10 years. Lack of donor organs means that Canadians desiring a kidney transplant can expect to wait up to 10 years for surgery. By increasing the donor pool through careful selection and also improving the longevity of transplants already performed, we can reduce the burden on the waitlist and improve the health of all Canadians living with renal disease. The amount of fibrotic change in the kidney determines the "quality" of the organ prior to implant as well as predicts how long it will last following transplantation. Beyond clinical assessment and renal function tests, both of which are insensitive to kidney fibrosis, biopsy of the kidney can be performed, but typically does not give adequate information to help in deciding if kidneys can be used or not. Biopsies are also performed after transplantation to survey kidney transplants' ongoing health, and while shown to give useful information, the procedure itself is painful and can potentially lead to bleeding, infection or even loss of the graft. We propose the development of an easy to use, noninvasive ultrasound based method of examining the kidney in order to determine kidney fibrosis, and eliminate the need for biopsy. Vibroelastography (VE) is a technique which examines the differential motion of structures through ultrasound, to determine the underlying tissues' relative stiffness. Kidneys have historically been found to be difficult to examine with VE due to their complex internal architecture, however we will refine the technology and perform a clinical study to compare VE results with conventional biopsy findings in kidney transplant patients. The findings from this work will provide doctors with the ability to improve both access to transplantation and lifespan of the kidney.