직렬 T-ID 모니터링 평가 관찰 연구 -ID-ENTITY (ID-ENTITY)
신장 이식 후 CMV 질환 및 BK 바이러스 관련 신병증 예방을 위한 직렬 T-ID 모니터링 평가에 관한 전향적, 다기관, 관찰 연구
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).
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
상세 설명
- 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.
연구 유형
연구 유형
등록 (추정된)
등록
연락처 및 위치
연구 장소
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Arizona
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Phoenix, Arizona, 미국, 85054
- Mayo Clinic Arizona
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California
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Los Angeles, California, 미국, 90095
- UCLA
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Los Angeles, California, 미국, 90033
- Keck Hospital of USC
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Kansas
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Kansas City, Kansas, 미국, 66160
- University of Kansas Medical Center
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Michigan
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Detroit, Michigan, 미국, 48202
- Henry Ford Health
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New Hampshire
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Lebanon, New Hampshire, 미국, 03756
- Dartmouth
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New Jersey
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Livingston, New Jersey, 미국, 07039
- Cooperman Barnabas Medical Center
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New York
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Buffalo, New York, 미국, 14215
- Erie County Medical Center
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North Carolina
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Greenville, North Carolina, 미국, 27834
- Eastern Carolina University, Brody School of Medicine
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Winston-Salem, North Carolina, 미국, 27157
- Atrium Health Wake Forest Baptist
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South Carolina
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Charleston, South Carolina, 미국, 29425
- Medical University of South Carolina
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Texas
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Dallas, Texas, 미국, 75230
- Dallas Renal Group
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Utah
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Murray, Utah, 미국, 84107
- Intermountain Health
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Virginia
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Falls Church, Virginia, 미국, 22042
- Inova Fairfax Hospital
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참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
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.
설명
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.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 관찰 모델: COHORT
- 시간 관점: PROSPECTIVE
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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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.
기간: 12 Months
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12 Months
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공동 작업자 및 조사자
간행물 및 유용한 링크
일반 간행물
- 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.
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
기타 연구 ID 번호
- TGRP32 ID-ENTITY
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
All data collected will be analyzed and submitted to Journals publications.
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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