NCT03326076

Brief Summary

This is an observational study to evaluate safety and efficacy outcomes in renal transplant recipients in whom post-transplant care is managed using AlloSure®. AlloSure® is a non-invasive test to measure donor-derived cell-free DNA (dd-cfDNA). The AlloSure test is intended to assess the probability of allograft rejection in kidney transplant recipients with clinical suspicion of rejection and to inform clinical decision-making regarding the necessity of renal biopsy in such patients at least 2 weeks post-transplant in conjunction with standard clinical assessment. Amendment 1 (A1): Is an observational study to develop and validate the clinical use of KidneyCare®.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
4,000

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jan 2018

Longer than P75 for all trials

Geographic Reach
1 country

72 active sites

Status
unknown

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

October 24, 2017

Completed
6 days until next milestone

First Posted

Study publicly available on registry

October 30, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

January 23, 2018

Completed
7.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2025

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2025

Completed
Last Updated

June 27, 2023

Status Verified

June 1, 2023

Enrollment Period

7.4 years

First QC Date

October 24, 2017

Last Update Submit

June 23, 2023

Conditions

Outcome Measures

Primary Outcomes (2)

  • Interstitial fibrosis/tubular atrophy (IF/TA) quantified by Banff Working Group biopsy grade(s) at 12 months post-transplant in AlloSure® and renal allograft biopsy managed patients

    Feb-2020

  • Total number of biopsies planned and performed post-transplant, including both surveillance and clinically indicated biopsies

    Feb-2020

Secondary Outcomes (9)

  • Transplant glomerulopathy (TG)

    Dec-2022

  • Patient and graft survival

    Dec-2022

  • Serum creatinine

    Dec-2022

  • Estimated glomerular filtration rate

    Dec-2022

  • Sensitivity of AlloSure for active rejection

    Dec-2022

  • +4 more secondary outcomes

Study Arms (5)

Primary donor-derived cell-free DNA

300 patients with planned renal surveillance biopsies at 12 months post-transplantation

Diagnostic Test: Donor-derived cell-free DNA (AlloSure®)

Control

A matched control cohort of 1000 patients with planned renal surveillance biopsies at 12 months post-transplantation but were not managed with donor-derived cell-free DNA (AlloSure®) or KidneyCare will be retrospectively selected

Other: Standard care

Secondary donor-derived cell-free DNA

1200 patients without planned renal surveillance biopsies at 12 months post-transplantation

Diagnostic Test: Donor-derived cell-free DNA (AlloSure®)

Primary KidneyCare®

300 patients with planned renal surveillance biopsies at 12 months post-transplantation

Diagnostic Test: Donor-derived cell-free DNA (AlloSure®)Diagnostic Test: Peripheral blood gene expression profiling (AlloMap Kidney)Diagnostic Test: Analytic platform (IBox)

Secondary KidneyCare®

1200 patients without planned renal surveillance biopsies at 12 months post-transplantation

Diagnostic Test: Donor-derived cell-free DNA (AlloSure®)Diagnostic Test: Peripheral blood gene expression profiling (AlloMap Kidney)Diagnostic Test: Analytic platform (IBox)

Interventions

Patients will receive donor-derived cell-free DNA testing for surveillance and for-cause. The planned surveillance will occur at months 1, 2, 3, 4, 6, 9, and 12 post-transplant and quarterly in year 2 and year 3.

Primary KidneyCare®Primary donor-derived cell-free DNASecondary KidneyCare®Secondary donor-derived cell-free DNA

Current standard methods for monitoring of renal allograft recipients for rejection (e.g. donor-specific antibodies, serum creatinine, proteinuria, renal allograft biopsy)

Control

Patients will receive peripheral blood gene expression profiling testing for surveillance and for-cause. The planned surveillance will occur at months 1, 2, 3, 4, 6, 9, and 12 post-transplant and quarterly in year 2 and year 3.

Primary KidneyCare®Secondary KidneyCare®

Patients will receive IBox testing for surveillance and for-cause. The planned surveillance will occur at months 1, 2, 3, 4, 6, 9, and 12 post-transplant and quarterly in year 2 and year 3.

Primary KidneyCare®Secondary KidneyCare®

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

All eligible renal transplant recipients who meet the inclusion/exclusion criteria will be a part of this observational study. The control cohort will include the patients cared for without the use of AlloSure® or KidneyCare at the participating centers who received their transplant in the 6 months prior to the enrollment start for the primary cohort.

You may qualify if:

  • Patient's health care provider adopts and intends to apply the center's AlloSure Routine Testing Schedule as part of the information used to manage the patient.
  • Subjects willing to provide written informed consent to participate.

You may not qualify if:

  • \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
  • Specimens from patients for whom any of the following are true will not be tested:
  • Recipients of transplanted organs other than kidney
  • Recipients of a transplant from a monozygotic (identical)
  • Recipients of a bone marrow transplant
  • Recipients who are pregnant
  • Recipients who are under the age of 18
  • Recipient who are less than 14 days post-transplant

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (72)

University of Alabama at Birmingham

Birmingham, Alabama, 35294, United States

Location

Loma Linda Medical Center

Loma Linda, California, 92354, United States

Location

Cedars-Sinai Medical Center

Los Angeles, California, 90043, United States

Location

University of Southern California

Los Angeles, California, 90089, United States

Location

University of California, Los Angeles

Los Angeles, California, 90095, United States

Location

Stanford Health Care

Palo Alto, California, 94304, United States

Location

UC Davis Medical Center

Sacramento, California, 95817, United States

Location

California Pacific Medical Center

San Francisco, California, 94115, United States

Location

University of California San Francisco

San Francisco, California, 94143, United States

Location

University of Colorado Hospital

Aurora, Colorado, 80045, United States

Location

University of Colorado- Anschutz Medical Campus

Aurora, Colorado, 80045, United States

Location

Yale University

New Haven, Connecticut, 06519, United States

Location

Georgetown University

Washington D.C., District of Columbia, 20007, United States

Location

George Washington University

Washington D.C., District of Columbia, 20037, United States

Location

University of Miami/Jackson Memorial Hospital

Miami, Florida, 33136, United States

Location

AdventHealth

Orlando, Florida, 32804, United States

Location

Tampa General Hospital

Tampa, Florida, 33606, United States

Location

Cleveland Clinic - Weston

Weston, Florida, 33331, United States

Location

Augusta University

Augusta, Georgia, 30912, United States

Location

Rush University Medical Center

Chicago, Illinois, 60612, United States

Location

University of Illinois at Chicago

Chicago, Illinois, 60612, United States

Location

University of Chicago

Chicago, Illinois, 60637, United States

Location

Loyola University

Maywood, Illinois, 60153, United States

Location

Indiana University

Indianapolis, Indiana, 46202, United States

Location

University of Kansas Medical Center

Kansas City, Kansas, 66160, United States

Location

University of Kentucky Chandler Hospital

Lexington, Kentucky, 40536, United States

Location

Tulane University Medical Center

New Orleans, Louisiana, 70112, United States

Location

Ochsner Foundation Hospital

New Orleans, Louisiana, 70121, United States

Location

Willis-Knighton Physician Network/ John C. McDonald Regional Transplant Center

Shreveport, Louisiana, 71103, United States

Location

University of Maryland

Baltimore, Maryland, 21201, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21205, United States

Location

Brigham and Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Massachusetts General Hospital

Boston, Massachusetts, 02144, United States

Location

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

University of Minnesota Medical Center

Minneapolis, Minnesota, 55455, United States

Location

University of Mississippi Medical Center

Jackson, Mississippi, 39216, United States

Location

The University of Missouri

Columbia, Missouri, 65212, United States

Location

Washington University (Barnes Jewish Hospital)

St Louis, Missouri, 63110, United States

Location

Washington University

St Louis, Missouri, 63110, United States

Location

University of Nebraska Medical Center

Omaha, Nebraska, 68105, United States

Location

Saint Barnabus Medical Center

Livingston, New Jersey, 07039, United States

Location

SUNY Downstate Medical Center

Brooklyn, New York, 11203, United States

Location

Erie County Medical Center

Buffalo, New York, 14215, United States

Location

Montefiore Medical Center

The Bronx, New York, 10467, United States

Location

Metrolina Nephrology Associates

Charlotte, North Carolina, 28207, United States

Location

Duke University

Durham, North Carolina, 22705, United States

Location

East Carolina University/Vidant Medical Center

Greenville, North Carolina, 27834, United States

Location

Wake Forest Baptist Medical Center- Department of General Surgery

Winston-Salem, North Carolina, 27157, United States

Location

Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States

Location

Ohio State University Medical Center

Columbus, Ohio, 43210, United States

Location

The Oklahoma Transplant Center at OU Medical Center

Oklahoma City, Oklahoma, 73104, United States

Location

Integris Baptist Medical Center

Oklahoma City, Oklahoma, 73112, United States

Location

Geisinger Clinic

Danville, Pennsylvania, 17822-4033, United States

Location

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Allegheny General Hospital

Pittsburgh, Pennsylvania, 15212, United States

Location

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, 15213, United States

Location

Rhode Island Hospital

Providence, Rhode Island, 02903, United States

Location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

Location

Methodist Healthcare Foundation

Memphis, Tennessee, 38104, United States

Location

Vanderbilt University Medical Center

Nashville, Tennessee, 37292, United States

Location

UT Southwestern

Dallas, Texas, 75390, United States

Location

Baylor All Saints Medical Center

Fort Worth, Texas, 76104, United States

Location

Texas Research Institute

Fort Worth, Texas, 76104, United States

Location

Houston Methodist Hospital

Houston, Texas, 77030, United States

Location

UT Health San Antonio

San Antonio, Texas, 78229, United States

Location

Baylor Scott & White Medical Center

Temple, Texas, 76508, United States

Location

Intermountain Medical Center

Murray, Utah, 84107, United States

Location

University of Utah

Salt Lake City, Utah, 84132, United States

Location

Inova Fairfax Hospital

Falls Church, Virginia, 22042, United States

Location

Virginia Commonwealth University

Richmond, Virginia, 23298, United States

Location

University of Washington Medical Center

Seattle, Washington, 98195, United States

Location

Sacred Heart Medical Center

Spokane, Washington, 99204, United States

Location

Related Publications (2)

  • Bloom RD, Bromberg JS, Poggio ED, Bunnapradist S, Langone AJ, Sood P, Matas AJ, Mehta S, Mannon RB, Sharfuddin A, Fischbach B, Narayanan M, Jordan SC, Cohen D, Weir MR, Hiller D, Prasad P, Woodward RN, Grskovic M, Sninsky JJ, Yee JP, Brennan DC; Circulating Donor-Derived Cell-Free DNA in Blood for Diagnosing Active Rejection in Kidney Transplant Recipients (DART) Study Investigators. Cell-Free DNA and Active Rejection in Kidney Allografts. J Am Soc Nephrol. 2017 Jul;28(7):2221-2232. doi: 10.1681/ASN.2016091034. Epub 2017 Mar 9.

    PMID: 28280140BACKGROUND
  • Grskovic M, Hiller DJ, Eubank LA, Sninsky JJ, Christopherson C, Collins JP, Thompson K, Song M, Wang YS, Ross D, Nelles MJ, Yee JP, Wilber JC, Crespo-Leiro MG, Scott SL, Woodward RN. Validation of a Clinical-Grade Assay to Measure Donor-Derived Cell-Free DNA in Solid Organ Transplant Recipients. J Mol Diagn. 2016 Nov;18(6):890-902. doi: 10.1016/j.jmoldx.2016.07.003. Epub 2016 Oct 7.

    PMID: 27727019BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Plasma from venous blood will be collected and cell-free DNA will be extracted from the plasma for analysis of donor-derived cell-free DNA

MeSH Terms

Interventions

Standard of Care

Intervention Hierarchy (Ancestors)

Quality Indicators, Health CareQuality of Health CareHealth Services AdministrationHealth Care Quality, Access, and Evaluation

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 24, 2017

First Posted

October 30, 2017

Study Start

January 23, 2018

Primary Completion

June 30, 2025

Study Completion

December 31, 2025

Last Updated

June 27, 2023

Record last verified: 2023-06

Locations