連続的T-IDモニタリングを評価する観察研究 -ID-ENTITY (ID-ENTITY)
腎移植後のCMV疾患およびBKウイルス関連腎症の予防のための連続的T-IDモニタリングを評価する前向き多施設共同観察研究
To evaluate the association between time-updated CMV and BK viral loads measured monthly by T-ID and the risk of CMV disease and/or biopsy-proven BK virus-associated nephropathy (BKVAN) during the first 12 months following kidney transplantation, accounting for the net immune environment (TTV viral load) and allograft injury (donor-derived cell-free DNA, dd-cfDNA).
調査の概要
詳細な説明
- To characterize time-updated viral detection patterns (e.g., transient vs sustained CMV or BK signals) identified by T-ID prior to development of CMV disease or BKVAN.
- To evaluate the clinical utility of T-ID monitoring, defined by the frequency and type of clinical management actions taken following test results.
- To estimate the diagnostic performance of T-ID for clinically meaningful viral infection compared with standard-of-care (PCR) testing and clinical adjudication.
- To quantify lead time between T-ID detection of viral cfDNA and standard-of-care confirmation or initiation of therapy.
- To assess the safety of biomarker-informed management, including both rejection following infection-directed management and infection following rejection-directed management.
研究の種類
入学 (推定)
連絡先と場所
研究場所
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Arizona
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Phoenix、Arizona、アメリカ、85054
- Mayo Clinic Arizona
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California
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Los Angeles、California、アメリカ、90095
- UCLA
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Los Angeles、California、アメリカ、90033
- Keck Hospital of USC
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Kansas
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Kansas City、Kansas、アメリカ、66160
- University of Kansas Medical Center
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Michigan
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Detroit、Michigan、アメリカ、48202
- Henry Ford Health
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New Hampshire
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Lebanon、New Hampshire、アメリカ、03756
- Dartmouth
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New Jersey
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Livingston、New Jersey、アメリカ、07039
- Cooperman Barnabas Medical Center
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New York
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Buffalo、New York、アメリカ、14215
- Erie County Medical Center
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North Carolina
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Greenville、North Carolina、アメリカ、27834
- Eastern Carolina University, Brody School of Medicine
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Winston-Salem、North Carolina、アメリカ、27157
- Atrium Health Wake Forest Baptist
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South Carolina
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Charleston、South Carolina、アメリカ、29425
- Medical University of South Carolina
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Texas
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Dallas、Texas、アメリカ、75230
- Dallas Renal Group
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Utah
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Murray、Utah、アメリカ、84107
- Intermountain Health
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Virginia
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Falls Church、Virginia、アメリカ、22042
- Inova Fairfax Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
All subjects who meet eligibility criteria will be enrolled. As this is a non-interventional study, the protocol does not mandate any specific diagnostic, therapeutic, or management interventions. Clinical management decisions, including adjustments to immunosuppression, antiviral therapy, diagnostic testing, and biopsy decisions, remain entirely at the discretion of the treating clinicians.
説明
Inclusion Criteria:
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Participants must meet all the following criteria:
- Written informed consent and HIPAA authorization obtained prior to any study-related data collection.
- Age ≥18 years at the time of enrollment.
- Recipient of a kidney transplant, including:
- Primary or repeat kidney transplantation
- Living-donor or deceased-donor transplantation
- At 1 month post-kidney transplant at the time of enrollment.
- Receiving maintenance immunosuppressive therapy per institutional standard of care.
- Selected by the treating provider to undergo TRAC testing as part of usual post-transplant clinical monitoring.
Exclusion Criteria:
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Recipient of a combined organ transplant involving a non-renal solid organ (e.g., kidney-liver, kidney-heart) and/or islet cell transplantation.
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History of prior non-renal solid organ transplantation or islet cell transplantation.
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Known pregnancy at the time of enrollment.
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Known active viral infection at enrollment with any of the following:
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Hepatitis B surface antigen (HBsAg)-positive
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Hepatitis B virus (HBV) nucleic acid testing (NAT)-positive
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Human immunodeficiency virus (HIV) infection or HIV NAT-positive
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*Known active BK virus-associated nephropathy (BKVAN) or CMV disease at the time of enrollment.
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Medical, psychiatric, or social condition that, in the opinion of the Investigator, would interfere with the participant's ability to provide informed consent or comply with study procedures.
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Concurrent participation in another investigational biomarker study designed to evaluate clinical utility of post-transplant molecular diagnostics.
- Participants with asymptomatic or low-level viral replication detected during routine clinical monitoring are eligible, provided there is no evidence of established CMV disease or BK virus-associated nephropathy at enrollment.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:COHORT
- 時間の展望:PROSPECTIVE
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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The primary endpoint of the study is the time to first occurrence of either cytomegalovirus (CMV) disease or biopsy-proven BK virus-associated nephropathy (BKVAN) during the first 12 months post-kidney transplantation.
時間枠:12 Months
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12 Months
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Lo DJ, Kaplan B, Kirk AD. Biomarkers for kidney transplant rejection. Nat Rev Nephrol. 2014 Apr;10(4):215-25. doi: 10.1038/nrneph.2013.281. Epub 2014 Jan 21.
- Friedewald JJ, Kurian SM, Heilman RL, Whisenant TC, Poggio ED, Marsh C, Baliga P, Odim J, Brown MM, Ikle DN, Armstrong BD, Charette JI, Brietigam SS, Sustento-Reodica N, Zhao L, Kandpal M, Salomon DR, Abecassis MM; Clinical Trials in Organ Transplantation 08 (CTOT-08). Development and clinical validity of a novel blood-based molecular biomarker for subclinical acute rejection following kidney transplant. Am J Transplant. 2019 Jan;19(1):98-109. doi: 10.1111/ajt.15011. Epub 2018 Aug 31.
- Park S, Guo K, Heilman RL, Poggio ED, Taber DJ, Marsh CL, Kurian SM, Kleiboeker S, Weems J, Holman J, Zhao L, Sinha R, Brietigam S, Rebello C, Abecassis MM, Friedewald JJ. Combining Blood Gene Expression and Cellfree DNA to Diagnose Subclinical Rejection in Kidney Transplant Recipients. Clin J Am Soc Nephrol. 2021 Oct;16(10):1539-1551. doi: 10.2215/CJN.05530421.
- Clinical Utility of Peripheral Blood Gene Expression Profiling of Kidney Transplant Recipients to Assess the Need for Surveillance Biopsies in Subjects with Stable Renal Function January 2017 Journal of Transplantation Technologies & Research 07(03) DOI: 10.4172/2161-0991.1000177 Martin Roy First Thomas C Whisenant John Friedewald Show all 10 authors Michael M Abecassis Citations 6 Reads 239
- Bouamar R, Shuker N, Hesselink DA, Weimar W, Ekberg H, Kaplan B, Bernasconi C, van Gelder T. Tacrolimus predose concentrations do not predict the risk of acute rejection after renal transplantation: a pooled analysis from three randomized-controlled clinical trials(dagger). Am J Transplant. 2013 May;13(5):1253-61. doi: 10.1111/ajt.12191. Epub 2013 Mar 8.
- Arms MA, Fleming J, Sangani DB, Nadig SN, McGillicuddy JW, Taber DJ. Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients. Surgery. 2018 Feb;163(2):430-435. doi: 10.1016/j.surg.2017.09.027. Epub 2017 Nov 22.
- Sinha R, Zhu Z, Park S, Rebello C, Kinsella B, Friedewald J, Kleiboeker S. Combined Metagenomic Viral Detection and Donor-Derived Cell-Free DNA Quantification in Plasma From Kidney Transplant Recipients. Transplant Proc. 2024 Jul-Aug;56(6):1522-1530. doi: 10.1016/j.transproceed.2024.06.003. Epub 2024 Jul 6.
- Loupy A, Haas M, Roufosse C, Naesens M, Adam B, Afrouzian M, Akalin E, Alachkar N, Bagnasco S, Becker JU, Cornell LD, Clahsen-van Groningen MC, Demetris AJ, Dragun D, Duong van Huyen JP, Farris AB, Fogo AB, Gibson IW, Glotz D, Gueguen J, Kikic Z, Kozakowski N, Kraus E, Lefaucheur C, Liapis H, Mannon RB, Montgomery RA, Nankivell BJ, Nickeleit V, Nickerson P, Rabant M, Racusen L, Randhawa P, Robin B, Rosales IA, Sapir-Pichhadze R, Schinstock CA, Seron D, Singh HK, Smith RN, Stegall MD, Zeevi A, Solez K, Colvin RB, Mengel M. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell- and antibody-mediated rejection. Am J Transplant. 2020 Sep;20(9):2318-2331. doi: 10.1111/ajt.15898. Epub 2020 May 28.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- TGRP32 ID-ENTITY
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
All data collected will be analyzed and submitted to Journals publications.
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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