Molecular Warehouse: Mobile-enabled molecular diagnostic for remote monitoring of kidney transplant patients

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There are 35,000 kidney transplant patients in UK (and over 500,000 across developedeconomies), who have to take immunosuppressant medication for the rest of their lives, inorder to avoid graft rejection.Modern immunosupressants have increased 10-year overall kidney graft survival to 60%compared with 40% from a decade prior. However, the narrow therapeutic index and interpatientlevel variability of immunosuppressants currently necessitates patient monitoring inthe clinic.Unfortunately, the burden on the time and cost on both patients and the healthcare systemresults in infrequent testing, which combined with lifestyle changes and poor medicationadherence, leads to immunosuppressant levels being poorly controlled, and concomitantly toshorter graft survival.Considering that the cost benefit of kidney transplantation compared to dialysis is £24,100 peryear for each year that the patient has a functioning transplanted kidney, each year ofimproved graft survival for the ~3,000 new kidney transplants per year in UK would save theNHS £72m per year.To solve this problem, Molecular Warehouse is developing a self-testing diagnostic device forthe rapid monitoring of immunosuppressants in kidney transplant patients. The test can beperformed at home on the patient’s smartphone, and results immediately sent wirelessly to anonline dashboard for review and confirmation by the prescribing doctor.This test will for the first time enable a patient-centric, precision-medicine approach toimmunosuppression therapy, improving transplant maintenance and patient quality of life, andreducing operational costs and waiting times in the NHS.After having developed a functional proof of concept of the system, this project will developthe pre-production prototype and initial clinical testing, in collaboration with leadingclinicians who have agreed to support this project to make this product available to patientsrapidly.