Gift hope this Christmas

At 19, Kelli was living and studying in Darwin with her two-year-old daughter when she was diagnosed with genetic kidney disease. It wasn’t until during her final pregnancy that Kelli underwent a kidney biopsy to try and understand the cause of loss of blood. Her kidney function was at 30%, and she was told within 5 years she would be on dialysis and in need of a transplant.

Kelli faced ongoing challenges over the next few years. From struggling to keep her calcium levels up, to undergoing a thyroidectomy, and balancing travelling for treatment, working and caring for her family, and advocating for her health. Kelli began to lose hope that she would receive a transplant due to antibodies she had acquired during pregnancy, making a match difficult. “I just couldn’t see the end of the line with a phone call being made for a transplant,” she says.

In 2016 May 16th forever became her ‘thank you day’ when she received the call for a lifesaving kidney transplant. Today Kelli is healthy and happy, working across a number of organisations towards culturally appropriate solutions to increase equity and access to kidney care and transplantation.

Kelli’s lifesaving kidney transplant has gifted her so many precious memories with her family. From welcoming three grandchildren into the world and witnessing her first granddaughter being born in December, to watching her eldest daughter graduate with a double degree, and so many more special moments she thought she wouldn’t get to see.

Your generosity this festive season will help even more Australian women living with CKD like Kelli embark on motherhood safely.

This is the focus of groundbreaking research led by Dr Erandi Hewawasam, aimed at investigating the safety of immunosuppressant drug Tacrolimus – a medication that lowers risk of rejection after an organ transplant – in cases of pregnancy.

Pregnancy increases blood volume and stresses the kidneys, leading to decreased Tacrolimus levels in the whole blood, which may not accurately reflect the drug’s availability in tissues. Dr Hewawasam’s research aims to develop a method for measuring plasma Tacrolimus concentrations, potentially
providing a more precise assessment of the drug during pregnancy.

Collecting blood samples from about 20 women taking Tacrolimus at various stages of pregnancy, the team will compare whole blood and plasma methods while monitoring outcomes like preeclampsia and preterm birth. The team hopes to demonstrate the role of plasma measurements in guiding safer and more effective dosing, ultimately reducing risks for mothers, babies and kidney transplant recipients.

During pregnancy, a woman’s body undergoes changes that affect how Tacrolimus is processed. Currently, doctors rely on whole blood measurements, but these levels drop during pregnancy due to increased blood volume and other physiological changes. Underdosing Tacrolimus increases the risk of transplant rejection, while overdosing can cause kidney and placenta toxicity, which may lead to pre-eclampsia and preterm birth.

Dr Hewawasam’s vital work aims to contribute to new guidelines for Tacrolimus dosing in pregnancy worldwide, significantly reducing complications and improving outcomes for transplant recipients who want to safely have children.