Prospective Pilot Study of Pre-Transplant Thymoglobulin Administration in Living Donor Renal Transplant Recipients
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Purpose
To determine how safe and effective giving Thymoglobulin before transplantation to patients who are going to be receiving kidney transplants.
| Condition | Intervention | Phase |
|---|---|---|
|
Organ Transplantation Transplantation Immunology |
Drug: anti-thymocyte globulin (rabbit) |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Prospective, Single Center, Pilot Study of Pretransplant Thymoglobulin Administration and Early Corticosteroid Withdrawal in Living Donor Renal Transplant Recipients Under Mycophenolate Mofetil (MMF) and Tacrolimus Maintenance Immunosuppression |
- Composite end point of acute rejection, graft survival or patient survival [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Incidence of treatment failures: defined as the percentage of patients that do not remain on initial therapy. [ Time Frame: Ongoing ] [ Designated as safety issue: No ]
- Incidence of infections [ Time Frame: Not defined ] [ Designated as safety issue: No ]
- Need for antilymphocyte antibody therapy to treat acute rejection [ Time Frame: Not defined ] [ Designated as safety issue: No ]
- Severity of biopsy-proven rejection using Banff 97 Criteria [ Time Frame: Not defined ] [ Designated as safety issue: No ]
- Delayed Graft Function [ Time Frame: Undefined ] [ Designated as safety issue: No ]
- Serum creatinine [ Time Frame: Post-operative days 1-7, 1, 3 and 6 months ] [ Designated as safety issue: No ]
- Malignancy [ Time Frame: Undefined ] [ Designated as safety issue: Yes ]
| Enrollment: | 11 |
| Study Start Date: | September 2008 |
| Study Completion Date: | July 2010 |
| Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Preloading Induction with Thymoglobulin® X 4 doses given day -4, day -2, day 0, and day 2 at 1.5 mg/kg/dose + corticosteroid taper + tacrolimus + MMF
|
Drug: anti-thymocyte globulin (rabbit)
Preloading Induction with Thymoglobulin® X 4 doses given day -4, day -2, day 0, and day 2 at 1.5 mg/kg/dose + corticosteroid taper + tacrolimus + MMF
Other Name: Thymoglobulin
|
|
Active Comparator: 2
Preloading Induction with Thymoglobulin® X 3 doses given day -4 (1.5mg/kg), day -2 (1.5mg/kg), and day 0 (3mg/kg) + corticosteroid taper + tacrolimus + MMF
|
Drug: anti-thymocyte globulin (rabbit)
Preloading Induction with Thymoglobulin® X 3 doses given day -4 (1.5mg/kg), day -2 (1.5mg/kg), and day 0 (3mg/kg) + corticosteroid taper + tacrolimus + MMF
Other Name: Thymoglobulin
|
Detailed Description:
We will evaluate the therapeutic efficacy of administering Thymoglobulin® induction pre-transplantation in renal allograft recipients. Patients receiving pre-transplant Thymoglobulin will be evaluated for acute rejection (Banff '97 criteria), survival, and safety at 6 months. Overall the use of Thymoglobulin induction pre-transplantation will be safe and effective.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adult living donor renal transplant recipient.
- Patient is at least 18 years of age
- If female and of childbearing potential, have a negative serum or urine HCG within 24 hours prior to Study Day -5 (Day of 1st Thymoglobulin dose) and must practice a medically approved method of birth control for the past 30 days prior to enrollment and agree to continue this practice during the 6 month efficacy analysis.
- Signed informed consent.
Exclusion Criteria:
- Human Leukocyte Antibody (HLA) identical living donor transplant recipient.
- History of a positive cross-match with the donor.
- Patients with a peak CDC PRA > 50% or a current CDC PRA > 25%.
- Patients who have previously received a kidney transplant.
- Active donor or recipient serology positive for human immunodeficiency virus (HIV), Hepatitis B virus (HBV), or Hepatitis C virus (HCV).
- History of noncompliance.
- History of chronic corticosteroid or immunosuppressive use except for inhaled corticosteroids to treat asthma. .
- Multiple organ transplant recipient.
- Patient with a urinary bladder that is absent or not functional (e.g. self catheterization) pretransplant.
- Patient who does not agree to use effective birth control during the 6-month efficacy analysis.
- Known contraindication to administration of rabbit antithymocyte globulin.
- Initial screening laboratory evaluations will be done locally before renal transplantation and the following laboratory values will be exclusionary: Platelets < 100,000/mm23 or WBC < 3000/mm3
- Currently abusing drugs or alcohol or, in the opinion of the investigator, is at high risk for poor compliance.
Patient who, in the opinion of the investigator, has significant medical or psychosocial problems or unstable disease states that would preclude participation in the study. Examples of significant problems include, but are not limited to, morbid obesity or severe cardiac disease.
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Contacts and Locations| United States, Ohio | |
| The Christ Hospital | |
| Cincinnati, Ohio, United States, 45219 | |
| Principal Investigator: | E. Steve Woodle, MD | University of Cincinnati |
| Principal Investigator: | Adele Rike, PharmD | The Christ Hospital |
More Information
No publications provided
| Responsible Party: | E. Steve Woodle, MD, FACS, University of Cincinnati |
| ClinicalTrials.gov Identifier: | NCT00771745 History of Changes |
| Other Study ID Numbers: | Pre-Tx Thymo |
| Study First Received: | October 10, 2008 |
| Last Updated: | July 9, 2012 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Antilymphocyte Serum Mycophenolate mofetil Tacrolimus Immunosuppressive Agents |
Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013