Ajay Israni, MD, MS, HHRI Interim President, completed his undergraduate training from Rutgers College with Highest Honors. In 1995, he received his MD from New York University School of Medicine with High Honors in Genetics. His clinical responsibilities included the care of patients with end-stage renal disease including those being treated with dialysis or renal transplantation.
Within eleven years, half of all kidney transplants received from deceased donors will fail in the recipient’s body. Patients whose transplant fails often will not receive a replacement kidney in time to save their lives. Kidney transplant failure is a growing problem in the US. In 2006, there were 17,000 kidney transplants in the US – a figure that will likely grow as Americans suffer from more chronic diseases.
Dr. Ajay Israni was exposed to the consequences of kidney transplant failure while caring for kidney recipients as a transplant nephrologist. He became interested in how genetic variability affected the long-term outcomes for the kidney recipients he treated.
When the human genome was mapped, researchers discovered that 90 percent of human genetic variability is due to single nucleotide changes, or polymorphisms, in the DNA molecule (nucleotides are the parts of the DNA molecule that look like steps in a ladder).
By understanding the effects genetic variations have on long-term kidney function, Israni hopes his work will provide critical information that could help increase the viable life-span of transplanted kidneys in recipients’ bodies. A deeper understanding of the genetic interactions at play in kidney transplants will allow doctors to clinically screen patients before a transplant. Once we have identified the genetic variants associated with poor long-term kidney transplant success, scientists will be able to develop new and specific strategies to target those patients who are at a higher risk of long-term kidney transplant failure.
To carry out his research, Dr. Israni is collecting samples from recipients and donors to sequence their genomes to see which gene variations lead to a higher rate of transplant failure. His approach is multi-disciplinary, looking at both the genetics and the way the drugs are metabolized by recipients. Genetic samples come from several sites around the US and Canada.
Dr. Israni’s work shows how our understanding of the human genome will allow doctors to consider the unique genetic make-up of each individual and prescribe treatment regimens specifically tailored to that individual’s needs.