- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04017338
Transplantation Using Hepatitis C Positive Donors, A Safety Trial
Transplantation Using Hepatitis C Positive Donors to Hepatitis C Negative Recipients: A Safety Trial
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Jordan Feld, MD, MPH
- Phone Number: 4584 416-340-4800
- Email: Jordan.Feld@uhn.ca
Study Contact Backup
- Name: Nellie Kamkar, MSc
- Phone Number: 6220 416-340-4800
- Email: Nellie.Kamkar@uhn.ca
Study Locations
-
-
Ontario
-
Toronto, Ontario, Canada, M5G 2N2
- Recruiting
- University Health Network Toronto General Hospital
-
Contact:
- Jordan Feld, MD, MPH
- Phone Number: 4584 416-340-4800
- Email: Jordan.Feld@uhn.ca
-
Contact:
- Nellie Kamkar, MSc
- Phone Number: 6220 416-340-4800
- Email: Nellie.Kamkar@uhn.ca
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Donor Inclusion Criteria:
- Age <70
- NAT+ HCV donor
Donor Exclusion Criteria:
- HIV positive or HTLV 1/2 positive
- Hepatitis B surface Antigen positive
- Any medical issues in the donor that would normally clinically exclude the donor (e.g. history of cancer, evidence of organ dysfunction, etc)
- Age>70
Recipient Inclusion Criteria:
- Recipients listed for kidney, kidney-pancreas, pancreas transplant alone, heart, or lung transplant
- HCV NAT negative
- Provides written informed consent
Recipient Exclusion Criteria:
- Chronic liver disease with > stage 2 fibrosis
- Participating in another interventional clinical trial
- Recipient listed for liver transplant
- Known allergy or contraindication to Glecaprevir/Pibrentasvir or ezetimibe
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Non Randomized Intervention
Intervention description: recipients on the wait-list for lung, heart, kidney, and/or pancreas transplants will all receive antiviral treatment in the form of 8 total doses of oral tablets. Lung recipients will also receive donor lungs that are treated with normothermic EVLP (details of both described below). Drug: All recipients will receive glecaprevir (300mg)/pibrentasvir (120mg) supplied as three tablets per dose 6-12 hours prior to transplant, and for 7 days post-transplant. Other Names: Maviret. Patients will also receive ezetimibe (10mg), supplied as one tablet per dose to be taken at the same time as Maviret tablets (6-12 hours prior to transplant in addition to 7 daily doses post-transplant). Ex Vivo Lung Perfusion (EVLP): Normothermic EVLP is a method of donor lung preservation, assessment, treatment, and repair of injured organs. This method allows donor lungs to be treated for at least 12h under protective physiological conditions. Other names: Normothermic EVLP. |
A potent and effective antiviral medication that has recently been approved for use in Canada with over 99% cure rates.
Other Names:
A cholesterol-lowering medication that also blocks entry of HCV into liver cells.
A technology that allows for the assessment and treatment of lungs prior to transplant.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Post-transplant Survival [Safety]
Time Frame: 6 months
|
Survival at 6 months post-transplantation in patients receiving organs from HCV-positive donors reported as a binary variable (survival: yes vs. no).
|
6 months
|
Incidence of HCV transmission [Safety]
Time Frame: 6 months
|
Incidence of HCV transmission following organ transplantation using HCV-positive donors.
The proportion who are HCV RNA positive by PCR at 6 months post-transplantation will be reported as a binary variable (transmission: yes vs. no).
|
6 months
|
Incidence of treatment-emergent adverse events [Safety and Tolerability]
Time Frame: 30 days
|
The number and type of adverse events that are related to treatment with glecaprevir/pibrentasvir or ezetimibe in the opinion of the investigator will be reported at 30 days.
|
30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Long-Term Organ Function using Spirometry for Lung Recipients
Time Frame: 1 year
|
Spirometry (also known as a pulmonary function test) will be used to assess lung function, measured as the Forced Vital Capacity (FVC) in liters.
|
1 year
|
Long-Term Organ Function using Exercise Tolerance for Lung Recipients
Time Frame: 1 year
|
A 6-minute walk test will also be used to assess lung function, measured as the total distance the patient can walk during the span of 6 minutes in meters).
|
1 year
|
Long-Term Organ Function for Pancreas Recipients
Time Frame: 1 year
|
Insulin dependency will be used to assess pancreas function in patients with diabetes, measured as the status of insulin freedom (not needing insulin) after the first year post transplantation.
The outcome will be reported as a binary variable (insulin freedom: yes vs. no).
|
1 year
|
Long-Term Organ Function for Kidney Recipients
Time Frame: 1 year
|
Creatinine levels will be used to assess kidney function and will be collected with a blood test.
The estimated glomerular filtration rate (eGFR) will then be calculated in milliliters per minute using serum creatinine (Scr).
The formula used to calculate eGFR will be using the Modification of Diet in Renal Disease (MDRD) equation, GFR (mL/min/1.73
m2) = 175 x (Scr)-1.154
x (Age)-0.203
x (0.742 if female) x (1.212 if African American)
|
1 year
|
Long-Term Organ Function for Heart Recipients
Time Frame: 1 year
|
Left ventricular ejection fraction (the amount of blood leaving the heart during each contraction) will be measured by echocardiography and will be expressed as a percentage.
|
1 year
|
Acute Cellular Rejection
Time Frame: 1 year
|
The incidence of acute cellular rejection following transplantation will be measured as the proportion of patients with biopsy-proven acute cellular rejection of the transplanted organ and will be reported as a binary variable (yes vs. no).
|
1 year
|
HCV Seroconversion
Time Frame: 1 year
|
HCV seroconversion will be measured as the proportion of patients who test positive for antibodies to HCV at 1 year post-transplant and will be reported as a binary variable (HCV antibody positive: yes vs. no)
|
1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Jordan Feld, MD, MPH, University Health Network Toronto General Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- RNA Virus Infections
- Virus Diseases
- Blood-Borne Infections
- Disease Attributes
- Liver Diseases
- Flaviviridae Infections
- Hepatitis, Viral, Human
- Enterovirus Infections
- Picornaviridae Infections
- Infections
- Communicable Diseases
- Hepatitis
- Hepatitis A
- Hepatitis C
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites
- Anticholesteremic Agents
- Hypolipidemic Agents
- Lipid Regulating Agents
- Ezetimibe
Other Study ID Numbers
- JF-8-2018
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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