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Mycophenolic acid (MPA) is a key anti-rejection drug for most children who receive a kidney transplant, yet many have large swings in MPA blood levels during the first 6 months after surgery—even with consistent dosing. This variability can contribute to serious side effects such as low white blood cell counts (higher infection risk) and may increase the risk of rejection or graft loss. Nearly one-third of pediatric recipients discontinue MPA within 2 years because it is difficult to tolerate, and current monitoring approaches are largely adapted from adult studies and may not reflect how children process the drug or what exposure levels trigger toxicity. We will study children at multiple time points within 6 months after transplant through a multi-centre Canadian cohort (Vancouver, Calgary, Edmonton, Toronto). We will identify patient factors (e.g., age, sex, kidney function, ethnicity, and time since transplant) that drive MPA exposure, define relationships between MPA levels and side effects, and build a predictive tool to support individualized dosing and proactive toxicity prevention. This work aims to reduce adverse events, improve graft survival and quality of life, and provide the institution with validated precision-dosing tools and multicentre data that strengthen clinical leadership, research capacity, and quality-improvement outcomes.
Tony Kiang
Taipei Medical University
Life Sciences
Education
University of Alberta
Globalink Research Award
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