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Renal Transplantation With Immune Monitoring

4. juni 2008 opdateret af: Washington University School of Medicine
The aim of this observational study is to evaluate an FDA approved immune system monitoring assay (Immunknow, Cylex Inc. Columbia, MD) in renal transplant recipients using standard immunosuppression and prophylaxis protocols from the time of transplantation through a twelve month follow-up period. The primary endpoint will be the incidence of acute rejection and infection and any correlation of these events to an assay that may be a measure of recipient immune response. Secondary endpoints will include evaluation of renal function, patient and graft survival, incidence of post-transplantation lymphoproliferative disorder and duration and extent of lymphocyte depletion.

Studieoversigt

Status

Afsluttet

Betingelser

Detaljeret beskrivelse

As compared to previous eras, renal transplantation is a procedure associated with low acute rejection rates and excellent one year graft survival. Despite this success, long term graft survival rates have not improved significantly. The reasons for late graft loss are multi-factorial, but include chronic rejection and infection. Thus, avoidance of chronic over immunosuppression is tantamount in avoiding graft or patient threatening infection, while avoidance of under immunosuppression is necessary to prevent graft loss from acute or chronic rejection. Renal allograft loss from a particular viral pathogen, BK virus, has become evident in the era of modern immunosuppression and likely reflects relative over immunosuppression. We, and others, have used BK detection as an imprecise marker of over immunosuppression to help guide adjustments in chronic immunosuppressive therapy. While screening for the presence of BK virus is helpful in avoiding over immunosuppression and potential graft loss from BK nephropathy, a correlate assay is not readily available that provides evidence of under immunosuppression, indicating risk of graft loss from rejection.

At present, a proven assay to measure the strength of the immune system is unavailable, and the only definite markers of over or under-immunosuppression remain infection and rejection, respectively. A tool to help tailor chronic immunosuppressive therapy and decrease the incidence of either of these two extremes would be of significant value in helping to prolong allograft survival and decrease the risk of immunosuppressive therapy in renal transplant recipients.

In this observational study, we plan to use a standard immunosuppressive regimen as well as standard infection prophylaxis with the addition of an immune monitoring assay (ImmunoKnow). This assay measures ATP production by recipient T cells and has been proposed as a marker of immune function. While of interest, there are as yet, no published studies describing the utility of this test for immune monitoring in adult renal transplant recipients. As this assay remains unproven as a viable tool to define over or under immunosuppression, we will be blinded to the ImmunoKnow results during the course of the study. The results from the immune monitoring assay will only be used in a retrospective analysis to determine if there is any clinically relevant correlation between the values obtained and episodes of rejection, infection, or the development of donor specific antibodies. If a significant correlation is suggested, further evaluation in subsequent studies and eventual incorporation into prospective patient care may be warranted.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

60

Kontakter og lokationer

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Studiesteder

    • Missouri
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Washington University School of Medicine/Barnes-Jewish Hospital

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 og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Kidney transplant recipients.

Beskrivelse

Inclusion Criteria:

  1. All consenting adult renal transplant recipients (age 18 years of age or older)
  2. Females of childbearing age must have a negative pregnancy test performed at the time of admission for transplantation
  3. Patient or guardian agrees to participate in the study and signs the informed consent.
  4. Patients already consented to another study, if allowed by the study sponsor and PI of that study.

Exclusion Criteria:

  1. Pregnant women or nursing mothers
  2. Any patient who, in the opinion of the investigator, has a significant medical or psychosocial problem that should preclude them from the study.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Samarbejdspartnere og efterforskere

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

Sponsor

Efterforskere

  • Ledende efterforsker: Matthew J Koch, MD, Washington University School of Medicine

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. oktober 2006

Studieafslutning (Faktiske)

1. maj 2008

Datoer for studieregistrering

Først indsendt

5. januar 2007

Først indsendt, der opfyldte QC-kriterier

5. januar 2007

Først opslået (Skøn)

8. januar 2007

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

5. juni 2008

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. juni 2008

Sidst verificeret

1. juni 2008

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 06-0867

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 .