MIC Cell Therapy for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients (TOL-1)
A Single-arm Phase-I Trial for the Determination of Safety and Feasibility of the Intravenous Administration of Mitomycin C-treated Donor Peripheral Blood Mononuclear Cells (MICs) for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients (TOL-1 Study)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
Baden-Wuerttemberg
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Heidelberg, Baden-Wuerttemberg, Germany, 69120
- University of Heidelberg
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Chronic kidney disease stage KDIGO 4 or 5
- First kidney transplant from a living donor
- Age ≥ 18 years
- ABO compatible
- CDC-PRA < 20%
- No donor-specific antibodies
- Negative CDC and ELISA crossmatch
- Immunosuppression with cyclosporin A, EC-MPS and methylprednisolone
- Informed consent
- Adequate contraception (women with child bearing potential)
Exclusion Criteria:
- Psychiatric disorder
- Heart failure (NYHA III or IV)
- Severe liver disease
- Active hepatitis B or C or HIV infection
- Active bacterial, fungal or viral disease
- Malignancy or malignancy in the last 5 years before screening
- Preexisting immunosuppression
- Vaccination with a live vaccine in the last 3 months before screening
- S/p splenectomy
- Substance abuse
- Pregnancy or lactation
- Women: Child/pregnancy with the intended donor
- Allergy against the investigational drug or part of it
- Other diseases that prohibit participation in the study (in the opinion of the investigator)
- Participation in an other interventional study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention arm
Patients receive MIC cell therapy together with standard immunosuppressive therapy
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MICs are given intravenously 2 or 7 days before kidney transplantation from a living donor
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The primary outcome measure is the frequency of adverse events after intravenous administration of MICs within 30 days after transplantation.
Time Frame: 30 days
|
30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Cumulative incidence of infection
Time Frame: 30 days
|
30 days
|
|
Cumulative incidence of CMV reactivation
Time Frame: 30 days
|
30 days
|
|
Number of patients with PTLD
Time Frame: 30 days
|
30 days
|
|
Number of patients with delayed graft function
Time Frame: 7 days
|
7 days
|
|
Number of patients with a pos. CDC and/or ELISA crossmatch
Time Frame: day -1 before transplantation
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day -1 before transplantation
|
|
Number of patients with DSA
Time Frame: day -1 before transplantation and day 7 and 30 after transplantation
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day -1 before transplantation and day 7 and 30 after transplantation
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|
Incidence of biopsy-proven cellular rejection
Time Frame: 30 days
|
30 days
|
|
Incidence of biopsy-proven antibody-mediated rejection
Time Frame: 30 days
|
30 days
|
|
Number of patients with stable graft function (S-creatinine < 2mg/dL)
Time Frame: 30 days
|
30 days
|
|
Patient and graft survival
Time Frame: 30 days
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Martin Zeier, MD, Heidelberg University
Publications and helpful links
General Publications
- Morath C, Schmitt A, Zeier M, Schmitt M, Sandra-Petrescu F, Opelz G, Terness P, Schaier M, Kleist C. Cell therapy for immunosuppression after kidney transplantation. Langenbecks Arch Surg. 2015 Jul;400(5):541-50. doi: 10.1007/s00423-015-1313-z. Epub 2015 Jun 17.
- Kleist C, Sandra-Petrescu F, Jiga L, Dittmar L, Mohr E, Greil J, Mier W, Becker LE, Lang P, Opelz G, Terness P. Generation of suppressive blood cells for control of allograft rejection. Clin Sci (Lond). 2015 May;128(9):593-607. doi: 10.1042/CS20140258.
- Dittmar L, Mohr E, Kleist C, Ehser S, Demirdizen H, Sandra-Petrescu F, Hundemer M, Opelz G, Terness P. Immunosuppressive properties of mitomycin C-incubated human myeloid blood cells (MIC) in vitro. Hum Immunol. 2015 Jul;76(7):480-7. doi: 10.1016/j.humimm.2015.06.008. Epub 2015 Jun 11.
- Terness P, Oelert T, Ehser S, Chuang JJ, Lahdou I, Kleist C, Velten F, Hammerling GJ, Arnold B, Opelz G. Mitomycin C-treated dendritic cells inactivate autoreactive T cells: toward the development of a tolerogenic vaccine in autoimmune diseases. Proc Natl Acad Sci U S A. 2008 Nov 25;105(47):18442-7. doi: 10.1073/pnas.0807185105. Epub 2008 Nov 18.
- Morath C, Schmitt A, Kleist C, Daniel V, Opelz G, Susal C, Ibrahim E, Kalble F, Speer C, Nusshag C, Pego da Silva L, Sommerer C, Wang L, Ni M, Huckelhoven-Krauss A, Czock D, Merle U, Mehrabi A, Sander A, Hackbusch M, Eckert C, Waldherr R, Schnitzler P, Muller-Tidow C, Hoheisel JD, Mustafa SA, Alhamdani MS, Bauer AS, Reiser J, Zeier M, Schmitt M, Schaier M, Terness P. Phase I trial of donor-derived modified immune cell infusion in kidney transplantation. J Clin Invest. 2020 May 1;130(5):2364-2376. doi: 10.1172/JCI133595.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TOL-1
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