NCT02294032

Brief Summary

The purpose of this study is to understand the role of specific B cells in activating or repressing an anti-allograft immune response after kidney transplantation. In this study, blood will be collected from kidney transplant patients during different timepoints, prior to and after their transplant. Knowledge gained from study findings will be used to develop therapeutic strategies to prevent antibody-mediated rejection, which is a major cause of long-term graft loss in kidney transplant patients.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
180

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Aug 2014

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 29, 2014

Completed
3 months until next milestone

Study Start

First participant enrolled

August 28, 2014

Completed
3 months until next milestone

First Posted

Study publicly available on registry

November 19, 2014

Completed
8.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 24, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 24, 2023

Completed
Last Updated

May 19, 2023

Status Verified

May 1, 2023

Enrollment Period

8.7 years

First QC Date

May 29, 2014

Last Update Submit

May 18, 2023

Conditions

Keywords

Bcellskidney allograft dysfunctionantibody mediated rejection

Outcome Measures

Primary Outcomes (1)

  • Blood collection prior to and after kidney transplantation

    Blood will be collected from kidney transplant patients prior to and after their transplant (1-, 3-, 6-, 12-, 18-, 24-, 36-, 48-, and 60- months post-transplant). We will try to better understand the role of specific B-cells after kidney transplant by using enzyme-linked immunosorbent assay (ELISA).

    1,3,6,12,18,24,36,48, and 60 months

Secondary Outcomes (1)

  • B cell count

    Up to 60 months

Study Arms (1)

Kidney Transplant

Patients who are about to undergo a kidney transplant and are on immunosuppressive agents.

Drug: Immunosuppressive Agents

Interventions

standard of care for patients post-transplant

Also known as: Prograf, Cellcept
Kidney Transplant

Eligibility Criteria

Age2 Years - 85 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

Pediatric and Adult patients who are on the waitlist for a kidney or liver, or are about to undergo kidney or liver transplantation.

You may qualify if:

  • Ability to understand and willingness to sign the written informed consent form (ICF). For pediatric patients, a parent or legal guardian must sign ICF
  • Either a Kidney or Liver transplant patient: 1) on the waitlist or 2) transplanted
  • Healthy volunteer samples collected to use as the control group for statistical validity

You may not qualify if:

  • Inability to make all of the required long-term post-transplant visits.
  • Females who are pregnant or nursing a child
  • Liver patients with hepatitis C virus

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Loma Linda University Medical Center, Transplantation Institute

Loma Linda, California, 92354, United States

Location

Related Publications (34)

  • Seron D, Moreso F, Arias M, Campistol JM, Curto J, Hernandez D, Morales JM, Sanchez-Fructuoso A, Abraira V; Spanish Late Allograft Dysfunction Study Group. Estimation of renal allograft half-life: fact or fiction? Nephrol Dial Transplant. 2011 Sep;26(9):3013-8. doi: 10.1093/ndt/gfq788. Epub 2011 Feb 3.

    PMID: 21292814BACKGROUND
  • Colvin RB, Hirohashi T, Farris AB, Minnei F, Collins AB, Smith RN. Emerging role of B cells in chronic allograft dysfunction. Kidney Int Suppl. 2010 Dec;(119):S13-7. doi: 10.1038/ki.2010.436.

    PMID: 21116310BACKGROUND
  • Newell KA, Asare A, Kirk AD, Gisler TD, Bourcier K, Suthanthiran M, Burlingham WJ, Marks WH, Sanz I, Lechler RI, Hernandez-Fuentes MP, Turka LA, Seyfert-Margolis VL; Immune Tolerance Network ST507 Study Group. Identification of a B cell signature associated with renal transplant tolerance in humans. J Clin Invest. 2010 Jun;120(6):1836-47. doi: 10.1172/JCI39933. Epub 2010 May 24.

    PMID: 20501946BACKGROUND
  • Sagoo P, Perucha E, Sawitzki B, Tomiuk S, Stephens DA, Miqueu P, Chapman S, Craciun L, Sergeant R, Brouard S, Rovis F, Jimenez E, Ballow A, Giral M, Rebollo-Mesa I, Le Moine A, Braudeau C, Hilton R, Gerstmayer B, Bourcier K, Sharif A, Krajewska M, Lord GM, Roberts I, Goldman M, Wood KJ, Newell K, Seyfert-Margolis V, Warrens AN, Janssen U, Volk HD, Soulillou JP, Hernandez-Fuentes MP, Lechler RI. Development of a cross-platform biomarker signature to detect renal transplant tolerance in humans. J Clin Invest. 2010 Jun;120(6):1848-61. doi: 10.1172/JCI39922. Epub 2010 May 24.

    PMID: 20501943BACKGROUND
  • Halloran PF. Immunosuppressive drugs for kidney transplantation. N Engl J Med. 2004 Dec 23;351(26):2715-29. doi: 10.1056/NEJMra033540. No abstract available.

    PMID: 15616206BACKGROUND
  • Barnett AN, Hadjianastassiou VG, Mamode N. Rituximab in renal transplantation. Transpl Int. 2013 Jun;26(6):563-75. doi: 10.1111/tri.12072. Epub 2013 Feb 18.

    PMID: 23414100BACKGROUND
  • Rehnberg M, Amu S, Tarkowski A, Bokarewa MI, Brisslert M. Short- and long-term effects of anti-CD20 treatment on B cell ontogeny in bone marrow of patients with rheumatoid arthritis. Arthritis Res Ther. 2009;11(4):R123. doi: 10.1186/ar2789. Epub 2009 Aug 17.

    PMID: 19686595BACKGROUND
  • Everly MJ. Understanding and addressing the humoral immune response in transplant recipients. Clin Transpl. 2012:225-7. No abstract available.

    PMID: 23721026BACKGROUND
  • Everly MJ. Immunosuppression regimens to address alloantibodies in transplant recipients. Clin Transpl. 2012:219-23.

    PMID: 23721025BACKGROUND
  • Kannabhiran D, Everly MJ, Walker-McDermott JK, Tiongko S, Friedlander R, Putheti P, Sharma V, Dadhania D. Changes in IgG subclasses of donor specific anti-HLA antibodies following bortezomib-based therapy for antibody mediated rejection. Clin Transpl. 2012:229-35.

    PMID: 23721027BACKGROUND
  • Thibault-Espitia A, Foucher Y, Danger R, Migone T, Pallier A, Castagnet S, G-Gueguen C, Devys A, C-Gautier A, Giral M, Soulillou JP, Brouard S. BAFF and BAFF-R levels are associated with risk of long-term kidney graft dysfunction and development of donor-specific antibodies. Am J Transplant. 2012 Oct;12(10):2754-62. doi: 10.1111/j.1600-6143.2012.04194.x. Epub 2012 Aug 6.

    PMID: 22883025BACKGROUND
  • Xu H, He X, Liu Q, Chen Y, Zhu Y, Shi D, Zhang X. The abnormal high expression of B cell activating factor belonging to TNF superfamily (BAFF) and its potential role in kidney transplant recipients. Cell Mol Immunol. 2008 Dec;5(6):465-70. doi: 10.1038/cmi.2008.58.

    PMID: 19118513BACKGROUND
  • Clatworthy MR, Espeli M, Torpey N, Smith KG. The generation and maintenance of serum alloantibody. Curr Opin Immunol. 2010 Oct;22(5):669-81. doi: 10.1016/j.coi.2010.08.018.

    PMID: 20932734BACKGROUND
  • Stegall MD, Raghavaiah S, Gloor JM. The (re)emergence of B cells in organ transplantation. Curr Opin Organ Transplant. 2010 Aug;15(4):451-5. doi: 10.1097/MOT.0b013e32833b9c11.

    PMID: 20613525BACKGROUND
  • Lynch RJ, Silva IA, Chen BJ, Punch JD, Cascalho M, Platt JL. Cryptic B cell response to renal transplantation. Am J Transplant. 2013 Jul;13(7):1713-23. doi: 10.1111/ajt.12308. Epub 2013 Jun 10.

    PMID: 23750851BACKGROUND
  • Anolik JH, Looney RJ, Lund FE, Randall TD, Sanz I. Insights into the heterogeneity of human B cells: diverse functions, roles in autoimmunity, and use as therapeutic targets. Immunol Res. 2009 Dec;45(2-3):144-58. doi: 10.1007/s12026-009-8096-7. Epub 2009 Apr 7.

    PMID: 19350211BACKGROUND
  • Kaminski DA, Wei C, Qian Y, Rosenberg AF, Sanz I. Advances in human B cell phenotypic profiling. Front Immunol. 2012 Oct 10;3:302. doi: 10.3389/fimmu.2012.00302. eCollection 2012.

    PMID: 23087687BACKGROUND
  • Anolik JH, Barnard J, Cappione A, Pugh-Bernard AE, Felgar RE, Looney RJ, Sanz I. Rituximab improves peripheral B cell abnormalities in human systemic lupus erythematosus. Arthritis Rheum. 2004 Nov;50(11):3580-90. doi: 10.1002/art.20592.

    PMID: 15529346BACKGROUND
  • Iwata S, Saito K, Tokunaga M, Yamaoka K, Nawata M, Yukawa S, Hanami K, Fukuyo S, Miyagawa I, Kubo S, Tanaka Y. Phenotypic changes of lymphocytes in patients with systemic lupus erythematosus who are in longterm remission after B cell depletion therapy with rituximab. J Rheumatol. 2011 Apr;38(4):633-41. doi: 10.3899/jrheum.100729. Epub 2010 Dec 15.

    PMID: 21159836BACKGROUND
  • Kinnunen T, Chamberlain N, Morbach H, Cantaert T, Lynch M, Preston-Hurlburt P, Herold KC, Hafler DA, O'Connor KC, Meffre E. Specific peripheral B cell tolerance defects in patients with multiple sclerosis. J Clin Invest. 2013 Jun;123(6):2737-41. doi: 10.1172/JCI68775. Epub 2013 May 15.

    PMID: 23676463BACKGROUND
  • Sanz I, Wei C, Lee FE, Anolik J. Phenotypic and functional heterogeneity of human memory B cells. Semin Immunol. 2008 Feb;20(1):67-82. doi: 10.1016/j.smim.2007.12.006. Epub 2008 Feb 6.

    PMID: 18258454BACKGROUND
  • Moens L, Wuyts M, Meyts I, De Boeck K, Bossuyt X. Human memory B lymphocyte subsets fulfill distinct roles in the anti-polysaccharide and anti-protein immune response. J Immunol. 2008 Oct 15;181(8):5306-12. doi: 10.4049/jimmunol.181.8.5306.

    PMID: 18832686BACKGROUND
  • Gambichler T, Tigges C, Burkert B, Hoxtermann S, Altmeyer P, Kreuter A. Absolute count of T and B lymphocyte subsets is decreased in systemic sclerosis. Eur J Med Res. 2010 Jan 29;15(1):44-6. doi: 10.1186/2047-783x-15-1-44.

    PMID: 20159671BACKGROUND
  • Adams AB, Newell KA. B cells in clinical transplantation tolerance. Semin Immunol. 2012 Apr;24(2):92-5. doi: 10.1016/j.smim.2011.08.019. Epub 2011 Sep 29.

    PMID: 21958959BACKGROUND
  • Bloom D, Chang Z, Pauly K, Kwun J, Fechner J, Hayes C, Samaniego M, Knechtle S. BAFF is increased in renal transplant patients following treatment with alemtuzumab. Am J Transplant. 2009 Aug;9(8):1835-45. doi: 10.1111/j.1600-6143.2009.02710.x. Epub 2009 Jun 12.

    PMID: 19522878BACKGROUND
  • Shlipak MG, Matsushita K, Arnlov J, Inker LA, Katz R, Polkinghorne KR, Rothenbacher D, Sarnak MJ, Astor BC, Coresh J, Levey AS, Gansevoort RT; CKD Prognosis Consortium. Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013 Sep 5;369(10):932-43. doi: 10.1056/NEJMoa1214234.

    PMID: 24004120BACKGROUND
  • Iwata Y, Matsushita T, Horikawa M, Dilillo DJ, Yanaba K, Venturi GM, Szabolcs PM, Bernstein SH, Magro CM, Williams AD, Hall RP, St Clair EW, Tedder TF. Characterization of a rare IL-10-competent B-cell subset in humans that parallels mouse regulatory B10 cells. Blood. 2011 Jan 13;117(2):530-41. doi: 10.1182/blood-2010-07-294249. Epub 2010 Oct 20.

    PMID: 20962324BACKGROUND
  • Lehnhardt A, Dunst F, van Husen M, Loos S, Oh J, Eiermann T, Koch M, Kemper MJ. Elevated serum levels of B-cell activating factor in pediatric renal transplant patients. Pediatr Nephrol. 2012 Aug;27(8):1389-95. doi: 10.1007/s00467-012-2142-8. Epub 2012 Mar 28.

    PMID: 22453734BACKGROUND
  • Banham G, Prezzi D, Harford S, Taylor CJ, Hamer R, Higgins R, Bradley JA, Clatworthy MR. Elevated pretransplantation soluble BAFF is associated with an increased risk of acute antibody-mediated rejection. Transplantation. 2013 Aug 27;96(4):413-20. doi: 10.1097/TP.0b013e318298dd65.

    PMID: 23842189BACKGROUND
  • Thien M, Phan TG, Gardam S, Amesbury M, Basten A, Mackay F, Brink R. Excess BAFF rescues self-reactive B cells from peripheral deletion and allows them to enter forbidden follicular and marginal zone niches. Immunity. 2004 Jun;20(6):785-98. doi: 10.1016/j.immuni.2004.05.010.

    PMID: 15189742BACKGROUND
  • Woodland RT, Schmidt MR. Homeostatic proliferation of B cells. Semin Immunol. 2005 Jun;17(3):209-17. doi: 10.1016/j.smim.2005.02.006.

    PMID: 15826826BACKGROUND
  • Smith SH, Cancro MP. Cutting edge: B cell receptor signals regulate BLyS receptor levels in mature B cells and their immediate progenitors. J Immunol. 2003 Jun 15;170(12):5820-3. doi: 10.4049/jimmunol.170.12.5820.

    PMID: 12794106BACKGROUND
  • Kandala NB, Connock M, Grove A, Sutcliffe P, Mohiuddin S, Hartley L, Court R, Cummins E, Gordon C, Clarke A. Belimumab: a technological advance for systemic lupus erythematosus patients? Report of a systematic review and meta-analysis. BMJ Open. 2013 Jul 19;3(7):e002852. doi: 10.1136/bmjopen-2013-002852. Print 2013.

    PMID: 23872289BACKGROUND
  • Vadasz Z, Toubi E. [Belimumab--the biological drug for systemic lupus erythematosus: as discussed during the American College of Rheumatology (ACR) conference - 2012]. Harefuah. 2013 May;152(5):304-6. No abstract available. Hebrew.

    PMID: 23885457BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Whole blood, and plasma or serum

MeSH Terms

Interventions

Immunosuppressive AgentsTacrolimusMycophenolic Acid

Intervention Hierarchy (Ancestors)

Immunologic FactorsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and UsesMacrolidesLactonesOrganic ChemicalsCaproatesAcids, AcyclicCarboxylic AcidsFatty AcidsLipids

Study Officials

  • Michael de Vera, MD, FACS

    Loma Linda University Medical Center

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
PROSPECTIVE
Target Duration
5 Years
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 29, 2014

First Posted

November 19, 2014

Study Start

August 28, 2014

Primary Completion

April 24, 2023

Study Completion

April 24, 2023

Last Updated

May 19, 2023

Record last verified: 2023-05

Data Sharing

IPD Sharing
Will not share

Locations