Immune Monitoring-Guided Individualized Tacrolimus Therapy in Renal Transplant Recipients: An Observational Study and PK/PD Modeling

September 6, 2026 updated by: Zhongnan Hospital
This study aims to resolve the clinical limitation that therapeutic drug monitoring (TDM) alone cannot accurately reflect the net immune status after kidney transplantation. Within 12 months post-transplantation, we will systematically characterize dynamic trajectories of biomarkers including TTV DNA load, lymphocyte subsets and cytokines, and quantify their correlations with BK virus infection (over-immunosuppression) and acute rejection (insufficient immunosuppression). By integrating tacrolimus pharmacokinetics (PK), pharmacogenomics and immune monitoring indicators, a population pharmacokinetic-pharmacodynamic (PopPK/PD) model will be established to provide evidence supporting the paradigm shift from concentration-based dosing to immune effect-guided precision dosing.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

50

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patients receiving primary allogeneic kidney transplantation

Description

Inclusion Criteria:

  1. Aged 18-65 years, no gender restriction.
  2. Patients receiving primary allogeneic kidney transplantation.
  3. Maintenance immunosuppressive regimen based on tacrolimus after transplantation, with complete records of tacrolimus dosage, administration time and therapeutic drug monitoring data available.
  4. Expected follow-up duration of at least 12 months at this center, and ability to complete scheduled blood and urine sample collection.
  5. Subjects who fully understand the study protocol with good compliance, and provide written informed consent.

Exclusion Criteria:

  1. Combined multi-organ transplantation (e.g., combined liver-kidney transplantation).
  2. ABO-incompatible transplantation or patients with high preformed donor-specific antibody (DSA) titers requiring special induction regimens due to high immunological risk.
  3. Patients with active HIV, HCV or HBV infection, or preoperative severe active infection requiring systematic anti-infective therapy.
  4. Patients with delayed graft function or graft loss within 1 week after surgery.
  5. Patients with severe hepatic or renal dysfunction.
  6. Participants enrolled in other interventional clinical trials.
  7. Pregnant or breastfeeding women.
  8. Other conditions judged inappropriate for study participation by investigators.

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Tacrolimus trough blood concentration
Time Frame: Routine follow-up time points within 12 months after kidney transplantation (1 week, 2 weeks, 1 month, monthly from 2 to 12 months post-operation)
Routine follow-up time points within 12 months after kidney transplantation (1 week, 2 weeks, 1 month, monthly from 2 to 12 months post-operation)

Secondary Outcome Measures

Outcome Measure
Time Frame
Immune monitoring biomarkers (TTV DNA load, lymphocyte subsets, cytokines)
Time Frame: Collected simultaneously with tacrolimus sampling at all follow-up visits within 12 months post-transplantation
Collected simultaneously with tacrolimus sampling at all follow-up visits within 12 months post-transplantation
BK virus infection, acute cellular rejection
Time Frame: Recorded and confirmed on the day of event occurrence during 12-month full follow-up
Recorded and confirmed on the day of event occurrence during 12-month full follow-up

Collaborators and Investigators

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

Sponsor

Zhongnan Hospital

Collaborators

Fudan University

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

September 6, 2026

First Submitted That Met QC Criteria

September 6, 2026

First Posted (Actual)

September 11, 2026

Study Record Updates

Last Update Posted (Actual)

September 11, 2026

Last Update Submitted That Met QC Criteria

September 6, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2026018k
  • 82574502 (Other Grant/Funding Number: National Natural Science Foundation of China)

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.

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