NCT04870437

Brief Summary

Chronic AntiBody-Mediated Rejection (cABMR) is the leading cause of late kidney transplant loss (after 1 year of kidney transplantation). Its therapeutic management is poorly codified and there is currently no treatment referring. Extracorporeal phototherapy (ECP) is a therapeutic apheresis that involves purifying mononucleated cells in the blood, exposing them to UltraViolet A (UVA) and re-injecting them to the patient. This treatment is used as common care in the first line as part of the treatment of cutaneous T lymphoma and in the second line as part of the graft versus host reaction after bone marrow allograft. The mechanisms underlying the action of the ECP are not well known. They are mediated by the reinjection of cells exposed to UVA which enter apoptosis and induce immunomodulation. Recent work during cABMR shows that TFH lymphocytes, the maturing population of B lymphocytes, are deregulated and activated. The hypothesis is that ECP can modulate T Follicular Helper (TFH) lymphocytes during cABMR.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
30

participants targeted

Target at below P25 for not_applicable

Timeline
6mo left

Started Apr 2022

Longer than P75 for not_applicable

Geographic Reach
1 country

4 active sites

Status
recruiting

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

Study Progress90%
Apr 2022Oct 2026

First Submitted

Initial submission to the registry

March 30, 2021

Completed
1 month until next milestone

First Posted

Study publicly available on registry

May 3, 2021

Completed
12 months until next milestone

Study Start

First participant enrolled

April 27, 2022

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 27, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 27, 2026

Last Updated

March 6, 2026

Status Verified

September 1, 2025

Enrollment Period

4.5 years

First QC Date

March 30, 2021

Last Update Submit

March 4, 2026

Conditions

Keywords

Chronic AntiBody-Mediated RejectionExtraCorporeal PhototherapyKidney Transplantation

Outcome Measures

Primary Outcomes (1)

  • Frequency of TFH cells and their activation markers

    Variation in the frequency of TFH cells and their activation markers under treatment.

    From the 1st session of ECP to 1 year after the 1st session

Secondary Outcomes (6)

  • Subsequent ECP response in patients with cABMR

    3 months of treatment per ECP

  • Concentration of pro and anti-inflammatory cytokines

    From the 1st session of ECP to 1 year after the 1st session

  • Concentration of circulating B-cell populations

    From the 1st session of ECP to 1 year after the 1st session

  • Measurement of genetic markers in TFH cells

    At 1 week of the 1st session of ECP and at 3 month after the 1st session

  • Comparison of clinical data of patients

    From the 1st session of ECP to 1 year after the 1st session

  • +1 more secondary outcomes

Study Arms (1)

Extracorporeal phototherapy

EXPERIMENTAL
Other: Extracorporeal phototherapy

Interventions

The principle of ECP is to collect mononucleated cells from the blood by centrifugation. After purification, the mononucleated cells are incubated ex-vivo with a photo-activatable DNA intercalating agent (8-methoxypsoralen, UVADEX®), then re-injected to the patient.

Extracorporeal phototherapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ECP treatment decision based on transplant team habits (care management)
  • Age ≥ 18 years
  • Affiliation to a French social security scheme
  • cABMR proven by a renal graft biopsy less than 3 months and meeting the following histological criteria:
  • allograft glomerulopathy (cg\>0, and maximum score cg2) or intimal fibrosis
  • C4d positive or ptc+g greater than or equal to 2
  • Presence of Donor Specific Antibody (DSA)
  • Interstitial Fibrosis and Tubular Atrophy (IFTA) less than or equal to 2
  • Glomerular filtration rate \> 30 mL/min/1.73 m2
  • Signed informed consent to participate in the study

You may not qualify if:

  • Active infection or infection with hepatitis B, C or HIV virus
  • Pregnant, breastfeeding or parturient woman
  • Person deprived of liberty by judicial or administrative decision
  • Person receiving psychiatric care under duress
  • Person subject to legal protection
  • Person out of state to express consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Chu Besancon

Besançon, France

RECRUITING

CHU Clermont Ferrand

Clermont-Ferrand, France

RECRUITING

Chu Saint Etienne

Saint-Etienne, France

RECRUITING

CHU de STRASBOURG

Strasbourg, France

RECRUITING

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
OTHER
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 30, 2021

First Posted

May 3, 2021

Study Start

April 27, 2022

Primary Completion (Estimated)

October 27, 2026

Study Completion (Estimated)

October 27, 2026

Last Updated

March 6, 2026

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will share

Data will be shared upon reasonable request. Only de-identified data will be shared. Any data collected during the study may be shared. The protocol will be shared initially. Other documents may be shared at a later date upon request (e.g., the CRF to allow a collaborator to select the data they wish to access). The recipients of the data will be researchers. The data will be available for any purpose deemed relevant by the study investigator, based on a protocol provided by the requester, after verification of the obtaining of regulatory approvals, including the favorable opinion of an ethics committee.

Shared Documents
STUDY PROTOCOL
Time Frame
The data will be shared after signing a negotiated data transfer agreement ( data access agreement), for the duration specified in the agreement.
Access Criteria
The data will be made available via secure transfer (sharing platform approved by the university hospital: BlueFiles or Oodrive).

Locations