Diane and I have deliberately chosen to financially support this particular research.
Jan Peter Veeneman
Entrepreneur
People who have undergone a kidney transplant remain dependent on medication. Jan Peter Veeneman and his wife Diane made a donation to the Erasmus University Rotterdam Fund for groundbreaking research at Erasmus MC into patient-specific medication after a kidney transplant.
Jan Peter Veeneman was in his late thirties when he realised that something was seriously wrong with his kidneys. He had been experiencing symptoms for some time: fatigue, itching, headaches. ''At the hospital, they found that my kidney function was minimal,'' says Veeneman some 25 years later. ''I didn't want to go on dialysis, so I received a treatment at Radboud Hospital that was new at the time. That kept me going for twenty years, after which the only option was a new kidney. My brother was the donor.''
Medication: one size does not fit all
''Transplantation is the best treatment for many patients with kidney failure,'' says Dr. Dennis Hesselink, internist-nephrologist at Erasmus MC. "But there are risks. First of all, the transplant may be rejected. The body identifies the donor kidney as something foreign and activates the immune system to eliminate this ''intruder''. Effective medication has been developed to combat this in recent decades. Nevertheless, one in five transplants is still rejected. In addition, dangerous side effects can occur precisely because the immune system is suppressed. These include infections and tumours, but paradoxically also kidney damage. It is therefore vitally important that patients take neither too little nor too much medication. Our research is focused on how we can personalise the medication."
Jan Peter Veeneman underwent a successful kidney transplant in 2019. He also takes medication every day. ''At the time, I asked on what basis my medication had been determined. I understood that it was largely based on body weight. But it makes quite a difference whether your body consists mainly of muscle or fat mass.'' Hesselink agrees: ''There are many variables, such as age, gender and medical history. Of course, as a doctor, you take these into account, but the dosage often remains somewhat trial and error. Thanks in part to the Erasmus Trust Fund, we can now investigate this scientifically.''
Growing mini kidneys in the laboratory
Following the donation from the Veeneman family, Dennis Hesselink, together with researchers from the university medical centres in Groningen and Nijmegen, received a grant from NWO (the Netherlands Organisation for Scientific Research). The title of the project: ''One Kidney for Life''.
Hesselink: ''Unfortunately, a donor kidney does not last a lifetime. You can imagine that a second transplant is a major undertaking for the patient. By gaining a better understanding of the medication, we hope to achieve a breakthrough in this area as well.'' Hesselink continues: ''In the laboratory, we are going to grow a kind of mini-kidneys from stem cells from donor kidneys.
We then test the medicines and observe how the tissue responds. This generates a large amount of data. Using artificial intelligence, we aim to identify patterns and write algorithms that tailor the optimal medication for the patient. The study has two further components. Hesselink: ‘Patients have to take the drugs for the rest of their lives. We know that not everyone does this faithfully, despite the sometimes serious consequences. We are working with psychologists to see how we can improve this. Finally, together with the Erasmus School of Health Policy & Management, we are examining the economic side. How can we offer the new drug therapy in a way that covers as many of the costs as possible?’
Grateful
''When I woke up after the transplant, it felt like I was on a plane,'' says Jan Peter Veeneman. "Taking off, flying through the grey clouds, and arriving in the intense blue sky. It was a gift. I have been reborn and can truly be there for my family again. We are extremely grateful. That is why Diane and I have consciously chosen to financially support this particular research. We want every kidney patient to experience this happiness."