Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Islet Cell Transplantation in Patients With Type I Diabetes With Previous Kidney Transplantation

28. februar 2017 opdateret af: Rodolfo Alejandro
The purpose of this study is to reverse hyperglycemia and insulin dependency, by islet cell transplantation, in patients with type 1 diabetes mellitus who have a stable kidney allograft.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

  1. To reverse hyperglycemia and insulin dependency by islet cell transplantation, in patients with Type 1 Diabetes Mellitus who have a stable kidney allograft;
  2. To eliminate the incidence of hypoglycemic coma and unawareness by islet cell transplantation;
  3. To assess long-term function of successful islet cell transplants;
  4. To determine whether the natural history of the microvascular, macrovascular and neuropathic complications of Diabetes Mellitus are altered following successful transplantation of islet cells.
  5. To assess the effect of exenatide to improve islet graft function and survival in subjects that demonstrate partial graft loss and have returned to using exogenous insulin.
  6. To assess the ability of exenatide to improve islet survival at time of islet transplantation

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

7

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Florida
      • Miami, Florida, Forenede Stater, 33136
        • Diabetes Research Institute

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 60 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Patients between 18 and 60 years of age.
  2. Patients with type 1 diabetes mellitus.
  3. Patients with a renal transplant that is more than 6 months old.
  4. Patients with stable renal graft function for the preceding 6 months, i.e. no episodes of rejection and changes in serum creatinine no more than 0.5 mg/dl from baseline.
  5. Patients who are taking tacrolimus, sirolimus +/- steroids for maintenance immunosuppression for at least 6 months and are tolerating levels satisfactory for islet transplantation without severe complications.
  6. Patients with a body mass index (BMI) of less than or equal to 26.

Exclusion Criteria:

  1. Stimulated or basal C-peptide > 0.3 ng/ml.
  2. Patients with unstable renal function - serum creatinine greater than 0.5 mg/dl above baseline.
  3. Patients with proteinuria (albuminuria > 300 mg in 24 hours +/- protein) of new onset since kidney transplantation. If proteinuria or albuminuria is thought to originate from the native kidney(s) this will not be an exclusion criterion.
  4. Patients with corrected creatinine clearance of less than 40.
  5. Patients weighing more than 80 kg.
  6. Patients with a body mass index (BMI) of greater than 26.
  7. Insulin requirement > 1.0 U/kg/d.
  8. Anemia (hemoglobin: males < 11.0 g/dl; females < 10.0 g/dl).
  9. Abnormal liver function tests (consistently > 1.5 x normal range).
  10. Unstable diabetic retinopathy.
  11. Evidence of acute or chronic active Epstein-Barr virus (EBV) infection (IgM ≥ IgG). Patients will be eligible if serological testing becomes consistent with previous exposure (i.e. IgG > IgM).
  12. Patients with history of malignancy or current malignancy other than non-melanomatous skin cancer, or finding of any lesions or symptoms during screening that are suspicious for malignancy, until properly investigated and ruled out.
  13. Patients with elevation of prostate-specific antigen > 4 unless malignancy has been excluded.
  14. Patients with unstable cardiovascular status.
  15. Patients with active infections until adequately treated, unless treatment is not judged as necessary by the investigators (including, but not limited to, mild skin and nail fungal infections).
  16. Patients with serological evidence of infection with HIV, human t cell lymphotropic virus 1 (HTLV 1), HTLV 2, or hepatitis B (patients with serology consistent with previous vaccination and a history of vaccination are acceptable).
  17. Patients with history and/or serological evidence of hepatitis C (those patients with hepatitis C, already transplanted in this protocol will continue in this trial).
  18. Positive tuberculin test (unless proof of adequate treatment for latent tuberculosis can be provided).
  19. Patients with active peptic ulcer disease, gallstones, hepatic hemangioma, or portal hypertension.
  20. Patients who are pregnant or breastfeeding, or who intend to procreate.
  21. Patients who are sexually active females who are not:

    • post-menopausal,
    • surgically sterile, or
    • using an acceptable method of contraception (oral contraceptives, Norplant, Depo-Provera, and barrier devices combined with spermicidal gel are acceptable; condoms used alone are not acceptable).
  22. Active alcohol or substance abuse; smoking in the last 6 months.
  23. Patients with evidence of sensitization, i.e. panel reactive antibody (PRA) testing greater than 20%.
  24. Lack of updated immunizations per current Centers for Disease Control (CDC) guidelines, as well as immunization against hepatitis B, pneumococcus, and influenza (during season), unless medically contraindicated.
  25. Patients with psychogenic factors, which are judged at psychological evaluation, which make it unsafe to undergo islet transplantation, or which preclude therapeutic compliance.
  26. Patients with any condition or any circumstance that would make it unsafe to undergo an islet transplant.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Islet Transplantation
Islet Transplantation in subjects with a previous kidney transplant.
Islet Transplantation in subjects with a previous kidney transplant.
Andre navne:
  • holm

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Insulin Independence.
Tidsramme: 1 year
Number of Participants who Achieved Insulin Independence at 1 Year
1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Stimulated C-peptide Greater Than 0.5 ng/ml
Tidsramme: 1 year
Partial graft function, as evidenced by basal C-peptide greater than 0.5 ng/ml
1 year
Reduction of Insulin Requirements
Tidsramme: 1year
Reduction in insulin requirements in those patients who do not achieve insulin independence
1year
Reduction in Severe Hypoglycemia, Improvement in Hypoglycemia Awareness
Tidsramme: 1 years
Elimination or reduction in the incidence of hypoglycemic coma or unawareness
1 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Rodolfo Alejandro, M.D., University of Miami

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. december 2000

Primær færdiggørelse (Faktiske)

1. maj 2014

Studieafslutning (Faktiske)

1. maj 2014

Datoer for studieregistrering

Først indsendt

14. april 2006

Først indsendt, der opfyldte QC-kriterier

14. april 2006

Først opslået (Skøn)

18. april 2006

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. april 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

28. februar 2017

Sidst verificeret

1. november 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • 2000/0329
  • 5R01DK055347 (U.S. NIH-bevilling/kontrakt)
  • 5R01DK025802 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .