Genomics of Kidney Transplantation
2 juin 2017 mis à jour par: National Institute of Allergy and Infectious Diseases (NIAID)
The major aim of this research study is to investigate the relationship between genetic variation in DNA (inherited code material in the cells of the body) and factors affecting transplant outcomes, like the drugs people receive or the way their immune systems work, for example.
To do this, investigators will collect blood samples from participants.
Genetic material will be separated from each blood sample and analyzed, looking for genetic variation.
Aperçu de l'étude
Statut
Complété
Description détaillée
In the past, the major problems in kidney transplantation were surgical complications, acute rejection, and infections. Right now, researchers are focusing on improving immune suppression therapy and achieving better long-term survival of kidney transplants. One of the ways to try to understand what causes loss of function after many years is to find out if there is a genetic factor involved.
There are a number of differences in specific genes that have been identified and are thought to affect transplant outcomes. Studying these gene variations (differences between people or differences between populations) is important in determining whether these variations are related to transplant outcomes and how this information can help patients achieve better long-term transplant survival.
Type d'étude
Observationnel
Inscription (Réel)
1552
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Alberta
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Edmonton, Alberta, Canada, T6G 2B7
- University of Alberta
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Alabama
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Birmingham, Alabama, États-Unis, 35294
- University of Alabama
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Minnesota
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Minneapolis, Minnesota, États-Unis, 55415
- Hennepin County Medical Center
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Minneapolis, Minnesota, États-Unis, 55414
- University of Minnesota
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Rochester, Minnesota, États-Unis, 55905
- Mayo Clinic
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
Targeted: 3000 Kidney or Kidney-pancreas transplant recipients and 1300 of the donors
La description
Inclusion Criteria:
- Kidney (or kidney-pancreas) transplant recipient no more than 10 days post-transplant or kidney donor no more than 30 days post-transplant or previously enrolled in Phase I of the Genomics of Kidney Transplantation Study;
- No organs other than kidney or pancreas transplanted simultaneously with the qualifying kidney transplant; and
- Participant or parent/guardian must be able to understand and provide written informed consent.
Inclusion for the Activity and mRNA Expression Cohort:
- Recipient enrolled in the Main Cohort Study;
- Informed consent for participation in the Activity and mRNA Expression Cohort;
- Age 18 years or greater as of day of transplantation;and
- Will receive tacrolimus, cyclosporine or mycophenolate as part of maintenance immunosuppression therapy.
Exclusion Criteria:
- Inability or unwillingness of the participant or parent/guardian to give a written informed consent or comply with the study protocol.
For the Activity and mRNA Expression Cohort:
- Inability or unwillingness of the participant or parent/guardian to give a written informed consent for participation in the Activity and mRNA Expression Cohort or comply with the study protocol.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
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Transplant Recipients Cohort
Main Study Cohort: Kidney (or kidney-pancreas) transplant recipients.
Enrollment for this cohort is closed.
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Transplant Donors Cohort
Main Study Cohort: The kidney donor for transplant recipients in this study.
Enrollment for this cohort is closed.
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Activity&mRNA Expression Substudy Cohort
A subset of subjects enrolled in the main study who will receive tacrolimus, cyclosporine or mycophenolate as part of maintenance immunosuppression therapy.
This group has a prospective observational cohort design.
Enrollment into the Activity and messenger ribonucleic acid (mRNA) Expression Cohort, occurring concurrently with enrollment of the rest of the study, will continue until either the required sample size of 600 is achieved or the protocol team terminates enrollment.
Participants in the Activity and mRNA Expression Cohort have additional blood draws up to 2 weeks prior to transplant, at week 1, Month 3 and Month 6 post-transplant.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Transplant recipient genotypes: time to chronic graft disfunction
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Transplant recipient genotypes: time to a persistent 25% decrease in Estimated Glomerular Filtration Rate (eGFR)
Délai: Day 0 to Year 5
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eGFR: Estimated GFR test results are a measure of kidney function.
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Day 0 to Year 5
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Transplant recipient genotypes: time to acute rejection
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Transplant recipient genotypes: time to allograft failure
Délai: Day 0 to Year 5
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allograft failure is defined as graft loss or participant death.
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Day 0 to Year 5
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Donor Genotypes: time to chronic graft dysfunction
Délai: Day 0 to Year 5
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The time to dysfunction of the donated organ.
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Day 0 to Year 5
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Donor Genotypes: time to a persistent 25% decrease in eGFR
Délai: Day 0 to year 5
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The time to a persistent 25% decrease in eGFR in the donated organ's recipient.
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Day 0 to year 5
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Donor Genotypes: time to allograft failure
Délai: Day 0 to Year 5
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The time to the failure of the donated organ (defined as graft loss or participant death).
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Day 0 to Year 5
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Recipient genotypes: time to select mycophenolate-related toxicities (leukopenia, anemia)
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Recipient genotypes: time to select Calcineurin Inhibitor (CNI)-related toxicities
Délai: Day 0 to Year 5
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Toxicities may include: new onset diabetes or nephrotoxicity.
CNI: calcineurin inhibitor
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Day 0 to Year 5
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Recipient genotypes: repeated measures of clinically obtained tacrolimus trough blood levels
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Recipient candidate genotypes: Calcineurin (CN) and IMPDH protein activity and expression
Délai: Day 0 to Year 5
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CN: Calcineurin.
IMPDH: Inosine-5'-monophosphate dehydrogenase
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Day 0 to Year 5
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Time to composite endpoint of graft loss or death or persistent 25% increase in serum creatinine
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Time to renal biopsy with presence of the following semi-quantitative pathology endpoints: patterns of Banff biopsy score, presence of circulating anti-donor anti-Human Leukocyte Antigen (HLA) antibodies, C4d positivity
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Slope of eGFR
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Delayed graft function
Délai: Day 0 to Year 5
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Day 0 to Year 5
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Time to Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) infection
Délai: Day 0 to Year 5
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EBV: Epstein-Barr virus.
CMV: cytomegalovirus.
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Day 0 to Year 5
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Collaborateurs
Les enquêteurs
- Chercheur principal: A Matas, MD, University of Minnesota
- Chaise d'étude: A Israni, MD, MS, University of Minnesota
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Oetting WS, Schladt DP, Dorr CR, Wu B, Guan W, Remmel RP, Ikle D, Mannon RB, Matas AJ, Israni AK, Jacobson PA; DeKAF Genomics and GEN03 Investigators. Analysis of 75 Candidate SNPs Associated With Acute Rejection in Kidney Transplant Recipients: Validation of rs2910164 in MicroRNA MIR146A. Transplantation. 2019 Aug;103(8):1591-1602. doi: 10.1097/TP.0000000000002659.
- Nguyen TT, Pearson RA, Mohamed ME, Schladt DP, Berglund D, Rivers Z, Skaar DJ, Wu B, Guan W, van Setten J, Keating BJ, Dorr C, Remmel RP, Matas AJ, Mannon RB, Israni AK, Oetting WS, Jacobson PA. Pharmacogenomics in kidney transplant recipients and potential for integration into practice. J Clin Pharm Ther. 2020 Dec;45(6):1457-1465. doi: 10.1111/jcpt.13223. Epub 2020 Jul 14.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 août 2012
Achèvement primaire (Réel)
1 janvier 2017
Achèvement de l'étude (Réel)
1 janvier 2017
Dates d'inscription aux études
Première soumission
17 octobre 2012
Première soumission répondant aux critères de contrôle qualité
25 octobre 2012
Première publication (Estimation)
26 octobre 2012
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
5 juin 2017
Dernière mise à jour soumise répondant aux critères de contrôle qualité
2 juin 2017
Dernière vérification
1 juin 2017
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- DAIT GEN-03
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