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Presenter: Peter, Nickerson, Winnipeg, MB, Canada
Authors: Peter Nickerson
Adequacy of immunosuppression is central to holding the alloimmune response in check. Clinicians and patients constantly seek to lower immunosuppressive therapy to minimize the risk for serious adverse events or avoid annoying side-effects leading to clinician-guided under immunosuppression and patient nonadherence. Unfortunately, at present there is no validated predictive biomarker to inform clinicians who can and cannot be safely minimized. The risk of minimization is de novo DSA resulting in antibody-mediated rejection, transplant glomerulopathy and premature graft failure. Moreover, once this process is underway, at present physicians have no effective therapy to turn it off. In the last few years it has been appreciated that computational approaches predicting potential antibody binding epitopes on the mismatched donor and the recipient HLA molecules can be used to predict alloimmune risk for de novo DSA, late acute rejections and graft failure. If this is further validated, then we may have for the first time a predictive biomarker able to aid clinicians safely personalize immunosuppressive therapy.
Peter Nickerson - Biography:
Dr. Peter Nickerson is a Distinguished Professor of Internal Medicine and Immunology and the Vice-Dean Research, Rady Faculty of Health Sciences at the University of Manitoba. He is the Medical Director of Transplant Manitoba and the Medical Advisor, Organ Donation and Transplantation Division, Canadian Blood Services (CBS).
Dr. Nickerson holds the Flynn Family Chair in Renal Transplantation at the University of Manitoba. Funded by the CIHR and NIH, his research program focuses on mechanisms underlying acute and chronic transplant rejection; developing non-invasive techniques for the diagnosis of renal allograft rejection; and health care system design to enhance access to transplant.
Robert Liwski - Biography:
Dr. Liwski obtained his PhD in Transplantation Immunology in 1999, his MD degree in 2003 and completed his fellowship training in Hematological Pathology in 2006, all at Dalhousie University. His research interests include transplantation immunology, ischemia reperfusion injury and optimization of diagnostic testing in transplantation. Dr. Liwski has developed several optimized HLA antibody testing methods including the Halifax/Halifaster flow crossmatch protocols and the Rapid Optimized Single Antigen Bead (ROB) assay. He was awarded the Canadian Association of Pathologists Junior Scientist Award for his research investigating the role of activated protein C in prevention of ischemia reperfusion injury and cancer metastasis.
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