Ignite Creation Date:
2024-05-05 @ 10:24 PM
Last Modification Date:
2024-10-26 @ 10:18 AM
Study NCT ID:
NCT01106027
Status:
TERMINATED
Last Update Posted:
2018-01-31
First Post:
2010-03-29
Brief Title:
Dosing Regimen of Eculizumab Added to Conventional Treatment in Positive Crossmatch Deceased Donor Kidney Transplant
Sponsor:
Mayo Clinic
Organization:
Mayo Clinic
Study Overview
Official Title:
A Single Center Open-label Study to Determine the Safety and Efficacy of a Dosing Regimen of Eculizumab Added to Conventional Treatment in the Prevention of Acute Humoral Rejection AHR in Positive Crossmatch Deceased Donor Kidney Transplantation
Status:
TERMINATED
Status Verified Date:
2018-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Difficulty enrolling competing industry-funded multi-center clinical trial
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The purpose of this study is to test whether a dosing regimen of eculizumab in addition to standard posttransplant care in positive crossmatch deceased donor kidney transplant recipients will reduce the incidence of acute humoral rejection AHR
Patients included in this study will be those who have demonstrable anti-human leukocyte antigen HLA antibody specific for their deceased donor It is our hypothesis that blockade of terminal complement activation with eculizumab at the time of transplant in combination with our current protocols will reduce the incidence of AHR in recipients of deceased donor kidney transplants who have anti-donor HLA antibody
Patients included in this study will be those who have demonstrable anti-human leukocyte antigen HLA antibody specific for their deceased donor It is our hypothesis that blockade of terminal complement activation with eculizumab at the time of transplant in combination with our current protocols will reduce the incidence of AHR in recipients of deceased donor kidney transplants who have anti-donor HLA antibody
Detailed Description:
A strongly positive crossmatch has long been considered an absolute contraindication to kidney transplantation and most patients with anti-HLA antibody never were able to receive a kidney transplant Over the past decade significant progress has been made in overcoming early antibody-mediated renal allograft injury Despite our best efforts transplantation in these patients is still complicated by a high rate of acute humoral rejection
While we have successfully transplanted more than 250 patients with DSA using living donors applying these protocols to recipients of deceased donors has been problematic This primarily is due to the fact that in contrast to living donation the timing of a deceased donor kidney transplant cannot be planned This leads to inadequate time to perform the multiple pretransplant plasmapheresis treatments needed to achieve a safe level of DSA at transplant Thus there is a major unmet need to develop therapy that will allow for the successful transplantation of deceased donor kidneys in recipients who have DSA
At the time of deceased donor kidney transplantation patients will undergo one plasmapheresis prior to surgery
Patients will be given 1200 mg of eculizumab intravenously over 30 minutes 1 hour prior to surgery
Patients will be given 900 mg of eculizumab on Day 1 post-transplant
Patients will then be given 900 mg of eculizumab weekly through 4 weeks post-transplant
At week 4 patients will be assessed for DSA Patients with total DSA normalized values 5000 will stop eculizumab treatment Patients with total DSA normalized values 5000 will continue eculizumab treatment every 14 days from week 5 through week 9 The dose will be increased to 1200 mg and dosing will now be every 2 weeks instead of weekly Similar discontinuation assessments will be performed at week 9 26 39 and 52
While we have successfully transplanted more than 250 patients with DSA using living donors applying these protocols to recipients of deceased donors has been problematic This primarily is due to the fact that in contrast to living donation the timing of a deceased donor kidney transplant cannot be planned This leads to inadequate time to perform the multiple pretransplant plasmapheresis treatments needed to achieve a safe level of DSA at transplant Thus there is a major unmet need to develop therapy that will allow for the successful transplantation of deceased donor kidneys in recipients who have DSA
At the time of deceased donor kidney transplantation patients will undergo one plasmapheresis prior to surgery
Patients will be given 1200 mg of eculizumab intravenously over 30 minutes 1 hour prior to surgery
Patients will be given 900 mg of eculizumab on Day 1 post-transplant
Patients will then be given 900 mg of eculizumab weekly through 4 weeks post-transplant
At week 4 patients will be assessed for DSA Patients with total DSA normalized values 5000 will stop eculizumab treatment Patients with total DSA normalized values 5000 will continue eculizumab treatment every 14 days from week 5 through week 9 The dose will be increased to 1200 mg and dosing will now be every 2 weeks instead of weekly Similar discontinuation assessments will be performed at week 9 26 39 and 52
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
True
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
True
Is an FDA AA801 Violation?:
None