Personalization of Immunosuppressive Medication for Kidney Transplant Recipients

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dc.contributor.advisorKoizumi, Naoru
dc.creatorNayebpour, Mohammad Mehdi
dc.date.accessioned2023-03-17T19:05:31Z
dc.date.available2023-03-17T19:05:31Z
dc.date.issued2022
dc.description.abstractThis thesis presents three independent essays for the fulfillment of doctoral dissertation in Public Policy. The common theme in these essays is the practice of personalized medicine for kidney transplant recipients. The field of kidney transplantation is one of the costliest fields in the healthcare system and it is paid by the Federal government. Increasing the quality of transplant outcomes has been a major focus for CMS, particularly for underserved populations such as African Americans who already face the worse transplant outcomes. Studies show that implementing personalized medicine practices increases the quality of care, reduces graft rejection and increases graft survival rates. Such results directly translate into reducing the cost of kidney care. In this manuscript I developed a personalized medicine model based on gut microbiome information and gene markers to optimize the administration of an immunosuppressive drug called Tacrolimus. This model shows to be superior than existing models in predicting optimum required dose. In the next step I investigated the role of gut microbiome in kidney transplant outcomes and used the change in the relative abundance of bacterial genera as a tool for predicting graft rejection and graft failure. Finally, the existing policies of insurance coverage for personalized medicine for kidney disease were surveyed. I present an argument that expanding Medicare coverage to personalized medicine for kidney transplant is essential. This 3-essay dissertation presents a package for extending our knowledge of personalized medicine in kidney disease and it offers possible tools for implementing such practices.
dc.format.extent115 pages
dc.format.mediumdoctoral dissertations
dc.identifier.urihttps://hdl.handle.net/1920/13141
dc.language.isoen
dc.rightsCopyright 2022 Mohammad Mehdi Nayebpour
dc.rights.urihttps://rightsstatements.org/vocab/InC/1.0
dc.subjectGut Microbiome
dc.subjectImmunosuppressive
dc.subjectKidney Transplant
dc.subjectPersonalized Medicine
dc.subjectPharmacogenomics
dc.subjectTacrolimus
dc.subject.keywordsPublic health
dc.subject.keywordsHealth sciences
dc.subject.keywordsMedicine
dc.titlePersonalization of Immunosuppressive Medication for Kidney Transplant Recipients
dc.typeText
thesis.degree.disciplinePublic Policy
thesis.degree.grantorGeorge Mason University
thesis.degree.levelDoctoral
thesis.degree.namePh.D. in Public Policy

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