• Blydt-Hansen, Tom

    Titles

    Investigator, BC Children's Hospital
    Associate Professor, Department of Pediatrics, UBC
    Director, Pediatric Multi Organ Transplant Program, BC Children's Hospital

    Degrees / Designations

    MD

    Primary Area of Research
    Childhood Diseases
    Secondary Area(s) of Research
    Phone
    604-875-2000 ext 4849
    Fax
    604-875-3649
    Lab Phone
    Mailing Address

    BC Children's Hospital Research Institute
    Room A4-192, 950 West 28th Avenue
    Vancouver, BC V5Z 4H4

    Affiliate Websites
    Research Areas
    • Pediatric kidney transplant

    • Injury phenotype

    • Rejection

    • Biomarkers

    • Metabolomics

    • Chemokines

    Summary

    Kidney transplantation is a life-saving treatment for children with end-stage kidney failure. A major threat to success is rejection, where the body’s immune system attacks and destroys the transplanted kidney. If rejection isn't treated early, it results in permanent injury that can lead to loss of the transplant and a return to dialysis. Currently, tests that monitor kidney function will miss early or mild rejection. Instead, we screen with repeated kidney biopsies, which are risky and unpleasant.

    This research program will use proven techniques to identify signs of kidney injury and rejection in the urine of children who have had a kidney transplant. It will focus on the first year after transplant, since this is the highest risk for rejection. We will look for metabolites and chemokines that we have tested before to identify when injury or rejection is present. Metabolites are small molecules produced by our cells as part of their function or as waste products. Chemokines are a different type of molecule that is produced by our immune system to signal inflammation. We already know some of the changes that occur with rejection. We now plan to validate that the same changes are present in other Canadian children with kidney transplants.


    We will ask children with a new kidney transplant and their families to participate in this study. They will provide a urine sample for analysis whenever they have a kidney biopsy and also at regular intervals after transplant. We will verify the metabolite and chemokine levels that are linked to rejection, and could predict rejection in other children. Once it has been refined, we will determine whether it improves outcome by using it as a test for real-time monitoring and limit our use of regular kidney biopsies. We hope to demonstrate that this will improve the accuracy to detect rejection early, reduce the number of biopsies and improve the health and long-term kidney function of children with a transplant.

    Current Projects

    The PROBE Multicenter Cohort study (Pediatric Renal transplant Optimization using BiomarkErs) is a CHIR funded program to identify urine biomarkers of kidney allograft injury such as acute rejection, in children after kidney transplantation. It follows on an initial cohort study that has identified urinary chemokines and metabolite profiles that accurately detect acute rejecton. The current study will validate these findings in a multi-center cohort, establish the time-course for appearance and disappearance of "risk" signals in the first year after transplant, and deterimine the whether these events which are not otherwise detectable are associated with worse long-term outcome as measured by histology, kidney function and development of de novo donor-specific antibodies.


    The CNTRP (Canadian National Transplant Research Program) is a CIHR co-funded large network of researchers who are collectively undertaking 6 unique research programs that are supported by 3 cores. This includes a pediatric solid organ transplant research program that will focus on age and developmental changes in the immune system, drug pharmacokinetics, viral infection susceptibility and systems-related issues affecting adherence across the spectrum of mid and late-adolescence.

    Selected Publications
    • Fathallah-Shaykh SA, Flynn JT, Pierce CB, Abraham AG, Blydt-Hansen TD, Massengill SF, Moxey-Mims MM, Warady BA, Furth SL, Wong CS. Progression of Pediatric CKD of Nonglomerular Origin in the CKiD Cohort. Clin J Am Soc Nephrol. 2015 Apr 7;10(4):571-7. doi: 10.2215/CJN.07480714. Epub 2015 Jan 29. PubMed PMID: 25635034.

    • Blydt-Hansen TD and Dart AB. 2014. How should we identify early chronic kidney disease risk in non-kidney transplant recipients? Pediatr Transplant 18(7):661-2. PMID: 25250968. DOI: 10.1111/petr.12356; 10.1111/petr.12356.

    • Blydt-Hansen TD, Gibson IW, Gao A, Dufault B, Ho J. 2014. Elevated urinary CXCL10-to-creatinine ratio is associated with subclinical and clinical rejection in pediatric renal transplantation. Transplantation . PMID: 25222013. DOI: 10.1097/TP.0000000000000419.

    • Blydt-Hansen TD, Sharma A, Gibson IW, Mandal R, Wishart DS. 2014. Urinary metabolomics for noninvasive detection of borderline and acute T cell-mediated rejection in children after kidney transplantation. Am J Transplant 14(10):2339-49. PMID: 25138024. DOI: 10.1111/ajt.12837.

    • Dart AB, Wicklow BA, Sellers EA, Dean HJ, Malik S, Walker J, Chateau D, Blydt-Hansen TD, McGavock JM, iCARE investigators. 2014. The improving renal complications in adolescents with type 2 diabetes through the REsearch (iCARE) cohort study: Rationale and protocol. Can J Diabetes 38(5):349-55. PMID: 25284698. DOI: 10.1016/j.jcjd.2014.07.224.

    • Knoll GA, Kokolo MB, Mallick R, Beck A, Buenaventura CD, Ducharme R, Barsoum R, Bernasconi C, Blydt-Hansen TD, Ekberg H, et al. 2014. Effect of sirolimus on malignancy and survival after kidney transplantation: Systematic review and meta-analysis of individual patient data. Bmj 349:g6679. PMID: 25422259. PMCID: PMC4241732. DOI: 10.1136/bmj.g6679.

    • Ruzicka M, Quinn RR, McFarlane P, Hemmelgarn B, Ramesh Prasad GV, Feber J, Nesrallah G, MacKinnon M, Tangri N, McCormick B, et al (Blydt-Hansen, TD). 2014. Canadian society of nephrology commentary on the 2012 KDIGO clinical practice guideline for the management of blood pressure in CKD. Am J Kidney Dis 63(6):869-87. PMID: 24725980. DOI: 10.1053/j.ajkd.2014.03.003.

    • Blydt-Hansen TD, Pierce CB, Cai Y, Samsonov D, Massengill S, Moxey-Mims M, Warady BA, Furth SL. Medication treatment complexity and adherence in children with CKD. Clin J Am Soc Nephrol. 2014 Feb;9(2):247-54. Primary/Senior Author, Published. PMID:24262500.

    • Wiebe C, Pochinco D, Blydt-Hansen T, Ho J, Birk P, Karpinski M, Goldberg A, Storsley L, Gibson I, Rush D, Nickerson P. Class II HLA Epitope Matching - A strategy to minimize  de novo donor specific antibody development and improve outcomes. Am J Transplant. 2014 Feb;9(2):247-54. Co-Author, Published. PMID:24164958.

    • Lugasi T, Achille M, Blydt-Hansen T, Clermont MJ, Geoffroy L, Legault L, Phan V, Bell LE. Assessment of Identity and Quality of Life in Diabetic and Renal Transplant Adolescents in Comparison to Healthy Adolescents. 2013 Sep;20(3):361-72. Co-Author, Published. PMID: 23645186.

    • Smith JM, Martz K, Blydt-Hansen T. Pediatric kidney transplant practice patterns and outcome benchmarks, 1987-2010: A report of the North American Pediatric Renal Trials and Collaborative Studies. Pediatr Transplant. 2013 Mar;17(2):149-157. Primary/Senior Author, Published. PMID: 23281637.

    Grants
    • Children's Hospital Foundation of Manitoba. "Pediatric Kidney Health and Transplant Education Resource: Pre-Transplant". December 2014. April 1 2015 - March 30 2016. PI: Julie Strong, Tom Blydt-Hansen.

    • Astellas Canada "PROBE Adherence: Therapeutic drug exposure and outcome in pediatric kidney transplant recipients converting from twice-daily tacrolimus to daily extended-release tacrolimus". June 2014 - May 2018. PI: Tom Blydt-Hansen.

    • Astellas Pharmaceuticals “The Transition of renal transplant and diabetic adolescent patients from child-centered to adult-centered health care: Evaluation of the impact of developmental and self-determination variables.” PI: Tziona Lugasi, Lorraine Bell, Tom Blydt-Hansen (collaborator).

    • Astellas Pharma Canada, Inc. “PROBE-Adherence: Therapeutic drug exposure and outcome in pediatric kidney transplant recipients converting from twice-daily tacrolimus to daily extended-release tacrolimus.” Apr 2014- Sept 2018. PI: Tom Blydt-Hansen, Beth Foster, Ian Gibson, Julie Ho, Peter Nickerson, Atul Sharma, David Wishart.

    • Canadian Institutes of Health Research (CIHR) “Canadian National Transplant Research Program (CNTRP).” Apr 2013- Mar 2018. PI: West L. Caulfield T, Hebert MJ, Humar A, Knoll G, Levings M, Mital S, Roy DC, Schultz K, Shapiro J, Tom Blydt-Hansen.

    • Children’s Hospital Foundation of Manitoba Inc. (Winnipeg) “Pediatric Transplant Recipient Coordinator Transplant Manitoba-Pediatric Kidney Program." Apr 2013-Jan 2014. PI: Strong J.,Tom Blydt-Hansen (co-applicant), McKenty D. 

    • Canadian Institutes of Health Research (CIHR) “Non-Invasive monitoring of pediatric kidney allograft injury to improve diagnosis and patient outcomes” Oct 2012- Sep 2017. PI: Tom Blydt-Hansen, Julie Ho, Peter Nickerson, David Wishart, Ian Gibson.

    • Canadian Institutes of Health Research (CIHR) “Applying Biomarkers to Long-term Effects in Child and Adolescent Cancer Treatment (ABLE Team).” Oct 2011-Sep 2016. PI: Schultz, Kirk Raymond, Tom Blydt-Hansen (collaborator), L.R. Brandao, R. Broady, B.C. Carleton, G. Cuvelier, M.R. Hayden, A.Y.Y. Lee, M.N.Pinsk, C.J.D. Ross, M. Spavor.

    • Canadian Diabetes Association “Improving cardiovascular risk in adolescents with diabetes through research (iCARE).” Jan 2011-Dec 2014. PI: Allison Dart, Tom Blydt-Hansen (co-investigator), J. McGavock, E. Sellers, H. Dean.

    • Canadian Institutes of Health Research (CIHR) “Steroid-induced Osteoporosis in the Pediatric Population: Canadian Incidence Study.” Mar 2003-present. PI: Leanne Ward, et al. Tom Blydt-Hansen (collaborator).

    Honours & Awards
    Research Group Members
    • Marisa Catapang

    • Susan McMurrich

    • Lise Bourrier

    • Drs. Julie Ho, David Wishart, Atul Sharma, Ian Gibson, Peter Nickerson & Seema Mital, with the PROBE study investigators

    • Drs. Lori West & Marie-Josée Hebert and the CNTRP study investigators

    • Drs. Brad Warady & Susan Furth and the CKiD study investigators

    • Dr. Allison Dard and the iCARE study investigators

    • Dr. Leanne Ward and the STOPP study investigators

    • Dr. Kirk Shultz and the ABLE study investigators