Congratulations CIHR Spring 2021 Project Grant Winners
Congratulations to the CDTRP members and their teams who were successful in the CIHR Spring Project Grant competition! We are looking forward to supporting these projects with PFD partnerships, trainee support, management resources, and communication and KT support.
See below a list of funded projects through CIHR grant competition.
Project Title: The Neurologic Physiology after Removal of Therapy (NeuPaRT) Study
- Gofton, Teneille
- Dhanani, Sonny
- Meade, Maureen
- Slessarev, Marat
Public and healthcare provider trust is the cornerstone of deceased organ donation. It is important to ensure that donors are dead and cannot suffer during the organ donation process. In donation after brain death, this is done by confirming that brain function has stopped permanently before organ retrieval. Because brain death is rare, donation after circulatory determination of death (DCDD) has become an important strategy for increasing donation opportunities. However, in contrast to donation after brain death, current DCDD protocol does not mandate confirmation of permanent cessation of brain function prior to organ retrieval. Instead, the medical community assumes-based on scientific principals-that brain function stops within 5 minutes of when the heart stops. However, some animal-based research suggests that brain function: (1) may persist beyond when the heart stops; and (2) can be restarted hours after the time of death. Without research in people regarding when brain function stops compared to when the heart stops, these reports may reduce public and healthcare provider trust in DCDD. Research in people is needed to maintain and promote stakeholder trust in the DCDD process, and to ensure that DCDD protocol protects donors from harm. We will determine when brain function stops relative to when the heart stops by monitoring electrical brain activity in patients who are taken off life support and progress to death in the intensive care unit. Our findings will increase trust in DCDD and help to protect donors from harm by providing data from people that will inform the best time for organ procurement in DCDD. This data will be critical for preserving and promoting public and healthcare provider trust in the DCDD process. This will also help address current shortages of organs in Canada, and save the lives of people urgently awaiting transplant.
Project Title: Filling Knowledge Gaps for the Success of Ontario Renal Plan 3
- Weir, Matthew
- Beaucage, Mary
- Blake, Peter
- Chanchlani, Rahul
- Clark, Edward
- Clemens, Kristin
- Dixon, Stephanie
- Harel, Ziv
- Jain, Arsh
- Molnar, Amber
- Silver, Samuel
- Sood, Manish
Improving the health of patients with kidney diseases requires effective partnerships among researchers, patients, doctors, and policy makers. Our Ontario-wide research program (ICES KDT) has been building these partnerships for seven years. Together, we conduct research to improve the health and experiences of patients with kidney disease. In 2012, CIHR awarded our team a five-year grant to provide a coordinated approach to kidney research. With this support, we published 28 studies and 20 policy reports. We also added three important kidney-related data sources to the main holdings at ICES, including data on kidney transplantation. In the current proposal, we are seeking support to continue conducting research that will focus on the issues that matter most to patients. In partnership with the Ontario Renal Network, we are planning to conduct studies that will address knowledge gaps in four areas: Mental health in kidney patients, drug safety, First Nations kidney health, and transplantation.
Project Title: Addressing Inequity and Optimizing Prioritization in Liver Transplantation: Application of Artificial Intelligence to Improve Clinical Practice and Survival
- Bhat, Mamatha
- Wang, Bo
- Xu, Wei
The current organ allocation system for liver transplantation (LT) was developed to prioritize the sickest patients and improve equality. However, access to LT has remained compromised among women and other subgroups. The current prioritization system does not adequately serve the changing LT candidate population, where there has been a dramatic increase in non-alcoholic fatty liver disease (NAFLD) and older patients with comorbidities. Organ supply is insufficient to meet the demand, and up to 25% die on the waiting list for LT in Canada. There is an urgent need to revise this prioritization system and make it more equitable. We have confirmed the significant inequalities and dynamics for specific patient subgroups (women, NAFLD, frailty, increasing age, cholestatic liver disease) on the waiting list. Additionally, the evolution in patient clinical characteristics is resulting in a predominance of cancer and cardiac complications after transplant. We have recently developed an Artificial intelligence (AI) algorithm to predict mortality after transplant and personalize patient care. In the proposed project, we will develop a uniquely Canadian framework beyond the MELD Na score using AI for equitable patient prioritization on the waitlist. We will also refine our AI-based algorithm to predict the major complications after LT and provide personalized recommendations for prevention and therapy. Despite a publicly funded health service and a generosity-base organ donation system, there remains an urgent need to reform the current prioritization system, as it is inequitable and results in excessive deaths of specific patient subgroups. We will use Canadian data aligned with new technology to serve patients more equitably on the waiting list and after transplant, and reset survival to normal based on personalized risk profiles.
Don’t forget if you are submitting a proposal to the CIHR Fall Project Grant Competition and are interested in CDTRP support, requests through the online form here are due September 1, 2021.