- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05282875
Anti-HLA Immunization And Immunosuppressive Therapy Management In Kidney Transplant Patients Returning to Dialysis
Evolution of Anti-HLA Immunization According to Immunosuppressive Therapy Management Modalities in Kidney Transplant Patients Returning to Dialysis in Lorraine Between January 2007 and December 2019
This study is an analytical observational retrospective cohort study. It is a single-center study conducted in the Nancy University Hospital.
End stage renal disease is the ultimate stage of the chronic kidney disease. Patients need extra-renal replacement techniques. Kidney transplantation is the most effective option for survival, quality of life and costs.
Then long-term immunosuppressive agents are required to prevent allograft rejection and improve graft survival.
The number of patients who return in dialysis after graft loss is increasing and accounts for 10% of incident dialysis patients and 14% of patients on the kidney transplant waiting list registered in 2019. This population may develop complications induced by end-stage renal disease and adverse events related to prolonged exposure to immunosuppressive agents.
There are currently no formal guidelines on the management of immunosuppressive agents when patients return to dialysis. Reduction or discontinuation of therapy appears to decrease cardiovascular, infectious, and neoplastic complications. However, continuing these treatments may limit anti-HLA sensitization which may access to retransplantation.
Only a few low-powered cohort studies have evaluated the impact of the management of immunosuppressive therapy on the HLA-sensitization.
The hypothesis of our study is that the continuation of immunosuppressive agents when patients return in dialysis may limit anti-HLA sensitization. Therefore, access to retransplantation could be facilitated.
The main objective is to compare the evolution of anti-HLA sensitization according to the management of immunosuppressive treatment after the return in dialysis (maintenance, reduction, cessation).
Secondary objectives are time to re-transplantation for patients on the transplant waiting list, survival of the new graft, patient survival, and dialysis complications (cardiovascular, infectious and neoplastic complications).
Study Overview
Status
Intervention / Treatment
Detailed Description
Cohort constitution :
The cohort of patients returning to dialysis after graft loss is extracted from the REIN (Réseau Epidémiologique et Information en Néphrologie) Lorraine registry, which follow all patients in end-stage renal failure under replacement therapy in the Lorraine region since 2001.
Patients returning to dialysis after graft loss between 1st January 2007 and 31st December 2019 are extracted from the register and included.
From this cohort, 3 groups were created according to the management of their immunosuppressive therapy : maintenance, reduction, and discontinuation. The immunological data of the patients are recovered from the HLA laboratory of the Nancy University Hospital.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Locations
-
-
Lorraine
-
Nancy, Lorraine, France, 54000
- Central HNF
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
The cohort of patients returning to dialysis after graft loss is extracted from the REIN Lorraine registry. Patients returning in dialysis after graft loss between 1st January 2007 and 31st December 2019 are included.
From this cohort, 3 groups were created according to the management of their immunosuppressive therapy : maintenance, reduction, and discontinuation. The immunological data of the patients are recovered from the HLA laboratory of the Nancy University Hospital.
Description
Inclusion Criteria:
- Patients included in the Lorraine regional REIN registry over the period 2007-2019,
- Returning in dialysis after a kidney transplantation, with a living or deceased donor.
- On haemodialysis or peritoneal dialysis.
- Registered or not on the waiting-list for retransplantation
Exclusion Criteria:
- Patients with graft dysfunction receiving a pre-emptive retransplantation
- Absence of serum tested for anti-HLA (human leukocyte antigen) antibodies after the return to dialysis.
- No information on immunosuppressive agents
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
kidney transplant patients returning to dialysis after graft loss
This cohort contains kidney transplant patients returning to dialysis after graft loss in Lorraine between 1 January 2007 and 31 December 2019. They are identified by the REIN registry of the Lorraine region. The REIN registry is a national database that contains multiple information on patients with chronic end-stage renal disease (type of nephropathy, type of replacement therapy, comorbidities). |
3 groups :
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Comparison of the evolution of anti-human leucocyte antigen sensitization according to the management of immunosuppressive therapy
Time Frame: baseline = return in dialysis, t1=6 months after return in dialysis
|
Evolution of the panel reactive antibody evolution 6 months after the return in dialysis
|
baseline = return in dialysis, t1=6 months after return in dialysis
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patients survival
Time Frame: baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
Patient survival after return in dialysis
|
baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
New transplantation
Time Frame: baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
Retransplantation after return in dialysis
|
baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
Graft Survival after retransplantation
Time Frame: baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
Graft Survival after retransplantation
|
baseline = return in dialysis, end of follow up = death or last follow-up or 31 december 2020
|
Incidence of infectious, neoplastic and cardiovascular events
Time Frame: baseline = return in dialysis, end of follow up = 1 year after return in dialysis
|
Incidence of infection, neoplastic and cardiovascular events after return in dialysis
|
baseline = return in dialysis, end of follow up = 1 year after return in dialysis
|
Collaborators and Investigators
Sponsor
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2021PI192
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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