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Study of Subclinical Viral Infection

7 juni 2012 uppdaterad av: Jodi Smith, Seattle Children's Hospital

Subclinical Viral Infection and Renal Allograft Injury

Chronic allograft injury is the leading cause of graft loss in renal transplantation. The shortage of available kidneys for transplantation has reached crisis levels with increasing numbers of waiting list mortalities. Strategies to prolong graft survival are urgently needed. The pediatric and young adult transplant population is one in which repeat transplantation is inevitable and therefore, this group is one who will especially benefit from intervention to prolong graft survival. The hypothesis of this proposal is that subclinical viral infection is a modifiable risk factor in the pathogenesis of chronic allograft injury. The young age of the proposed study population is an ideal one to evaluate this objective due to the high prevalence of seronegative recipients. The studies outlined will determine the temporal relationship betWeween subclinical viremia, renal allograft infection and allograft injury. This will be the first prospective study in renal transplant recipients to systematically monitor subclinical viral infection both in peripheral blood and in the renal allograft with concurrent quantitative measures of renal function, allograft fibrosis, and innate immune activation. The investigators have chosen these 3 outcomes because they evaluate a spectrum of renal allograft injury and represent different stages - from early to late - in the pathophysiology that leads to renal allograft dysfunction. In addition, the role of virus specific T cell immune responses in the control of subclinical viral infection and associated allograft injury will be determined. These data are critical as they will provide insights into the pathogenesis of injury and will guide development of interventions strategies. Importantly, the current treatment strategies for viral disease do not prevent subclinical viral infection. Thus, the results of this study may identify that prevention, prophylaxis and/or treatment of subclinical viral replication as a long term strategy to prevent chronic allograft injury and prolong graft survival.

Studieöversikt

Status

Okänd

Betingelser

Studietyp

Observationell

Inskrivning (Förväntat)

100

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

Förenta staterna
- Washington
  - Seattle, Washington, Förenta staterna, 98105
    - Rekrytering
    - Seattle Children's Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

1 år till 25 år (Barn, Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Icke-sannolikhetsprov

Studera befolkning

Pediatric and young adult renal transplant recipients (1<25yrs) of their first kidney transplant from Seattle Children's Hospital and University of Washington Medical Center.

Beskrivning

Inclusion Criteria:

Subject and/or parent guardian must be able to understand and provide informed consent or assent
Male or Female, Seattle Children's Hospital participants must be 1-<21 yrs and University of Washington Medical Center participants 18-25yrs.
Diagnosed with End Stage Renal Disease (ESRD)

Exclusion Criteria:

Inability or unwillingness of subject and/or parent guardian to provide informed consent
Pregnancy

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Vad mäter studien?

Primära resultatmått

Resultatmått	Åtgärdsbeskrivning	Tidsram
Change in measured GFR from baseline Tidsram: time of transplant, one time between months 3 and 6, and during months 12, and 24 after the transplant	Single infusion of iohexol clearance to measure GFR	time of transplant, one time between months 3 and 6, and during months 12, and 24 after the transplant

Sekundära resultatmått

Resultatmått	Tidsram
Change in interstitial fibrosis and tubular atrophy of renal allograft from baseline Tidsram: Renal biopsies will be performed at time of transplant, 3-6 m, 12m, and 24m post-transplant. Precise measures of renal function, allograft fibrosis, and innate immune activation will be performed at baseline, 6m, 12, 24m post-transplant.	Renal biopsies will be performed at time of transplant, 3-6 m, 12m, and 24m post-transplant. Precise measures of renal function, allograft fibrosis, and innate immune activation will be performed at baseline, 6m, 12, 24m post-transplant.
Change in innate immune activation of renal allograft from baseline Tidsram: 6, 12, and 24 months after the transplant	6, 12, and 24 months after the transplant

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Seattle Children's Hospital

Samarbetspartners

University of Washington

Utredare

Huvudutredare: Jodi Smith, MD, Seattle Children's Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 oktober 2011

Primärt slutförande (Förväntat)

1 oktober 2016

Avslutad studie (Förväntat)