- To compare immunosuppressant drug pharmacokinetic parameters and patient dosing requirements in Aboriginal versus non-Aboriginal adult kidney transplant recipients.
- To identify whether changes to immunosuppressive protocols are required to reduce immunosuppressant drug inefficacy and toxicities in Aboriginal Australians, and thereby improve kidney transplant outcomes.
Aboriginal Australians are more than three times as likely to die or lose their transplanted kidney compared with non-Aboriginal Australians.
While the higher number of co-existing diseases in the Aboriginal population and poorer compatibility with donor kidney tissue account for some failures, Aboriginal kidney transplant recipients also have increased deaths due to infection.
Evidence suggests that some ethnic groups metabolise certain medications differently and the aim of this study is to investigate for differences in processing of anti-rejection medicines between Aboriginal and non-Aboriginal Australians.
Implications for policy and practice:
It is possible that different processing of immunosuppressive medications by Aboriginal people might contribute to poorer outcomes and therefore different dosing strategies might be necessary to improve Aboriginal kidney transplant outcomes.
This study has national significance and relevance not only for kidney transplant recipients but also for Aboriginal recipients of other organ transplants.
Our research has found:
Aboriginal Australians experience worse graft and patient outcomes following kidney transplantation compared with non-Aboriginal Australians. In a retrospective analysis of Aboriginal kidney transplant outcomes between 2001 and 2011, 15 percent of patients experienced an infectious complication within the first two years post transplantation, which resulted in either death or loss of graft function and a subsequent return to dialysis.
- Dr Katherine Barraclough, Royal Melbourne Hospital
The project commenced in May 2016 and is due for completion in June 2020.
- The Royal Australasian College of Physicians.
Foundation award for Katherine Barraclough, research establishment award.
This project is a collaboration with Melbourne Health and Menzies School of Health Research, who is managing the project. Participating sites include:
- Royal Darwin Hospital
- Alice Springs Hospital
- Royal Adelaide Hospital
- Fiona Stanley Hospital