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Novel Kidney Injury Tools in Deceased Organ Donation to Predict Graft Outcomes

Award Number: R01DK093770
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2012
PERIOD OF PERFORMANCE END DATE: 11/30/2026

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Novel Kidney Injury Tools in Deceased Organ Donation to Predict Graft Outcomes - Efforts to meet the increasing need for kidney transplantation have resulted in more kidney procurements from older and sicker donors, but have also unfortunately led to greater discard rates of procured kidneys. Although a subset of these organs are unsuitable for transplantation, many kidneys are unnecessarily discarded due to the inability to accurately assess graft quality and predict graft outcomes, often driven by unfavorable scores on the kidney donor profile index (KDPI), a widely used but inadequate metric for evaluating the quality of donated kidneys. The objective of the Deceased Donor Study is to gain insight into the biological processes that affect kidney quality during donor death and organ procurement. Phases 1 and 2 of the study generated novel insights into donor pathophysiology and revealed limitations in organ quality assessment, which motivate this renewal application. After evaluating >30 urine biomarkers collected from >1,500 donors, a protective effect for increasing donor urinary levels of repair biomarkers (e.g., YKL-40, uromodulin, and osteopontin), on long- term graft function in >2,500 recipients was demonstrated. In phase 3, these urinary repair biomarker results will begin to be validated and implemented in organ allocation process using real-time point-of-care tests. In collaboration with organ procurement organizations, repair biomarkers in samples from 500 donors with acute kidney injury (AKI) or high-risk KDPIs will be measured prospectively on site. Additional racial diversity will be included in our cohort in collaboration with the multicenter APOL1 Long- term Kidney Transplantation Outcomes Network to assess the differential response in recipient allograft outcomes to the APOL1 genotype more commonly present in Black donors. Lastly, in collaboration with the United Network for Organ Sharing laboratory, “adjusted” KDPIs will be provided for donors with AKI based on creatinine trajectory, genetic risk variants, and biomarker information, with the aim of improving kidney acceptability. These new tools may also provide a platform for enhancing understanding of the natural history of deceased-donor kidney transplantation, advancing the science of renal injury and repair as it relates to donor race, and determining the best approaches for transplanting kidneys at risk for discard.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $613,979 )
2025	2025	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	12	11/28/2024	NON-COMPETING CONTINUATION	$613,979
														Subtotal = $613,979

Issue Date FY: 2024 ( Subtotal = $663,452 )
2024	2024	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	11	5/1/2024	NON-COMPETING CONTINUATION	$41,466
2024	2024	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	11	11/17/2023	NON-COMPETING CONTINUATION	$621,986
2024	2020	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	9	10/23/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $663,452

Issue Date FY: 2023 ( Subtotal = $776,713 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	10	12/16/2022	COMPETING CONTINUATION	$776,713
2023	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	9	12/8/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $776,713

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	9	9/16/2022	SUPPLEMENT FOR EXPANSION	$0
2022	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	9	9/15/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $1,339,469 )
2020	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	9	9/15/2020	SUPPLEMENT FOR EXPANSION	$0
2020	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	9	7/23/2020	NON-COMPETING CONTINUATION	$621,451
2020	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	9	9/11/2020	SUPPLEMENT FOR EXPANSION	$718,018
														Subtotal = $1,339,469

Issue Date FY: 2019 ( Subtotal = $650,142 )
2019	2019	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	8	8/23/2019	NON-COMPETING CONTINUATION	$650,142
2019	2018	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	7	11/16/2018	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$545,166
2019	2017	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	6	11/16/2018	NON-COMPETING CONTINUATION	-$545,166
														Subtotal = $650,142

Issue Date FY: 2018 ( Subtotal = $709,939 )
2018	2018	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	7	8/17/2018	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$709,939
2018	2017	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	6	8/16/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $709,939

Issue Date FY: 2017 ( Subtotal = $622,825 )
2017	2017	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	003	6	8/11/2017	NON-COMPETING CONTINUATION	$622,825
2017	2016	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	5	2/22/2017	COMPETING CONTINUATION	$810,003
2017	2015	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	4	2/22/2017	NON-COMPETING CONTINUATION	-$666,093
2017	2014	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	2/22/2017	NON-COMPETING CONTINUATION	-$143,910
														Subtotal = $622,825

Issue Date FY: 2016 ( Subtotal = $705,780 )
2016	2016	YALE UNIVERSITY	47 College Street	NEW HAVEN	CT	06520	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	5	9/20/2016	COMPETING CONTINUATION	$705,780
2016	2015	YALE UNIVERSITY	47 College Street	NEW HAVEN	CT	065208047	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	9/19/2016	NON-COMPETING CONTINUATION	$0
														Subtotal = $705,780

Issue Date FY: 2015 ( Subtotal = $666,093 )
2015	2015	YALE UNIVERSITY	47 College Street	NEW HAVEN	CT	06520	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	7/7/2015	NON-COMPETING CONTINUATION	$666,093
														Subtotal = $666,093

Issue Date FY: 2014 ( Subtotal = $682,638 )
2014	2014	YALE UNIVERSITY	47 College Street	NEW HAVEN	CT	06520	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	6/26/2014	NON-COMPETING CONTINUATION	$682,638
														Subtotal = $682,638

Issue Date FY: 2013 ( Subtotal = $662,952 )
2013	2013	YALE UNIVERSITY	PO BOX 208250	NEW HAVEN	CT	06520	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	6/27/2013	NON-COMPETING CONTINUATION	$662,952
														Subtotal = $662,952

Issue Date FY: 2012 ( Subtotal = $758,026 )
2012	2012	YALE UNIVERSITY	PO BOX 208250	NEW HAVEN	CT	06520	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	8/13/2012	NEW	$758,026
														Subtotal = $758,026

Grand Total All Awards = $8,852,008

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Novel Kidney Injury Tools in Deceased Organ Donation to Predict Graft Outcomes

Award Number: R01DK093770

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2012

PERIOD OF PERFORMANCE END DATE: 11/30/2026

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