Renal TransplantationNCT00419575
Renal Transplantation With Immune Monitoring
An observational study of Renal Transplantation and Immunosuppression, run by Washington University School of Medicine at 1 site in United States.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Renal Transplantation, Immunosuppression
- How many people
- 60 participants
- Where
- 1 siteUnited States
- Study dates
- Oct 2006to May 2008
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Kidney transplant recipients.
Who may be able to join
- All consenting adult renal transplant recipients (age 18 years of age or older)
- Females of childbearing age must have a negative pregnancy test performed at the time of admission for transplantation
- Patient or guardian agrees to participate in the study and signs the informed consent.
- Patients already consented to another study, if allowed by the study sponsor and PI of that study.
Who cannot join
- Pregnant women or nursing mothers
- Any patient who, in the opinion of the investigator, has a significant medical or psychosocial problem that should preclude them from the study.
Trial locations and contacts
1 site in 1 country.
United States1 site
Washington University School of Medicine/Barnes-Jewish Hospital
St Louis, Missouri, 63110
About this study
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.
Read the detailed description
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.
- Conditions
- Renal Transplantation, Immunosuppression
- Keywords
- renal, transplantation, immunosuppression, monitoring
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jan 2007 (estimated)
- Study startOct 2006
- Study completionMay 2008
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Renal TransplantationStudies of the same condition, open and under way.
- More trials run by Washington University School of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Prospective
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Washington University School of Medicine
- Sponsor type
- University, hospital or other
- Investigators
- Matthew J Koch, MD, Principal investigator, Washington University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00419575
- Sponsor's protocol ID
- 06-0867
- Status last verified
- Jun 2008
- First submitted
- 5 Jan 2007
- Last updated
- 5 Jun 2008
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 Jun 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Renal Transplantation With Immune Monitoring
- ClinicalTrials.gov ID
- NCT00419575
- Acronym / sponsor ID
- 06-0867
- Conditions
- Renal Transplantation, Immunosuppression
- Keywords
- renal, transplantation, immunosuppression, monitoring
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Washington University School of MedicineUniversity, hospital or other
- Study start
- Oct 2006
- Study completion
- May 2008 (actual)
- First posted
- 8 Jan 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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.
Study design
- Observational model
- Case only
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Kidney transplant recipients.
Key inclusion criteria (4 listed)
- All consenting adult renal transplant recipients (age 18 years of age or older)
- Females of childbearing age must have a negative pregnancy test performed at the time of admission for transplantation
- Patient or guardian agrees to participate in the study and signs the informed consent.
- Patients already consented to another study, if allowed by the study sponsor and PI of that study.
Key exclusion criteria (2 listed)
- Pregnant women or nursing mothers
- Any patient who, in the opinion of the investigator, has a significant medical or psychosocial problem that should preclude them from the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jun 2008.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Matthew J Koch, MD principal investigator
Washington University School of Medicine
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Renal Transplantation and Immunosuppression, run by Washington University School of Medicine at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Jun 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jun 2008.