Optimization of Therapeutic Drug Monitoring in Pediatric Kidney Transplant

August 17, 2026 updated by: Abbie Leino, Children's Hospital Medical Center, Cincinnati

Optimization of Therapeutic Drug Monitoring for Tacrolimus and Mycophenolate in Pediatric Kidney Transplant Recipients: a PK/PD Study

The goal of this observational, pharmacokinetic study is to evaluate factors that change drug exposure in pediatric kidney transplant recipients so investigators can make better dosing decisions. The main question it aims to answer is:

Can investigators quantify the impact of factors that change with time (like food intake and medication adherence) on tacrolimus and mycophenolate? Our hypothesis is that inconsistent drug and food intake will increase day to day variability in drug exposure, and investigators can use this information to help us make decisions about what is the best dose.

Participants will participate in the study on 7 days over the course of 1 year. On day 1, participants will be asked questions to see if participants are able to be in this study. Investigators will ask what immunosuppression participants are taking, how tall and how much participants weigh.

On day 2, participants and their parent/guardian will be taught how to use the device to collect the blood samples and decide on which days to collect them.

On days 3-6, participants will collect blood samples 4 separate times over about 1 year. Collection days should try to be scheduled every 3 months (+/- 2 weeks).

On each collection day, participants will collect a sample 7 different times over 9 hours. Each collection will only take approximately 5 minutes. Participants will be asked to collect a blood sample immediately before the morning dose of tacrolimus or mycophenolate, and 20 min, 1hr, 3hr, 4hr, 6hr, 9hr after the dose.

Also on collection days, participants will receive text messages and be asked to complete different assessments about their medications, diet, and how they feel by responding to the texts.

On day 7, participants will have the opportunity to participate in an interview where investigators will ask about participants' experience in the study.

Study Overview

Status

Not yet recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

25

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Cincinnati Children's Hospital

Description

Inclusion Criteria:

  • Recipient of a solid organ transplant and at least 1 year of age
  • Receiving tacrolimus and/or mycophenolate
  • Patient and/or caregiver is willing to receive text notifications and has a mobile device capable of receiving and sending text and multimedia messages.
  • Ability to understand and willingness to sign a written informed consent
  • Ability to understand, read, and speak English.

Exclusion Criteria:

  • History of allergy to tape adhesives

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Longitudinal Self-Sampling for Immunosuppression Pharmacokinetics
Cohort of pediatric kidney transplant recipients self-collecting blood samples for assessment of intrapatient pharmacokinetic variability over 1 year

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Tacrolimus AUC
Time Frame: From enrollment for 1 year (samples every 3 months)
Tacrolimus AUC (total exposure) will be estimated from the 7 tacrolimus blood concentrations using a population pharmacokinetic model
From enrollment for 1 year (samples every 3 months)
Mycophenolic acid AUC
Time Frame: From enrollment for 1 year (samples collected every 3 months)
Mycophenolic acid AUC (total exposure) will be estimated from the 7 tacrolimus blood concentrations using a population pharmacokinetic model
From enrollment for 1 year (samples collected every 3 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Children's Hospital Medical Center, Cincinnati

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2028

Study Registration Dates

First Submitted

August 13, 2026

First Submitted That Met QC Criteria

August 13, 2026

First Posted (Actual)

August 18, 2026

Study Record Updates

Last Update Posted (Actual)

August 19, 2026

Last Update Submitted That Met QC Criteria

August 17, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2026-0136

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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.

Subscribe